What is Intrahepatic Cholestasis of Pregnancy?
Intrahepatic Cholestasis of Pregnancy (ICP) is a family of liver disorders that occur only during pregnancy and are characterized by elevated bile acids in the patient’s blood. ICP can pose a risk to the unborn baby. ICP is caused by a genetic predisposition paired with hormonal and environmental factors.
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What are the Symptoms of Intrahepatic Cholestasis of Pregnancy (ICP)?
The primary (and often only) symptom of Intrahepatic Cholestasis of Pregnancy is moderate to intense itching. Often the itching is concentrated on hands/wrists and ankles/feet, however it can also be generalized or affect other areas such as the scalp, arms, and legs. Many people experience worsening itching at night.
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How is Intrahepatic Cholestasis of Pregnancy Diagnosed?
Diagnosis of Intrahepatic Cholestasis of Pregnancy requires a bile acid test, sometimes called serum bile acids, total bile acids, or bile salts. Bile acids over 10 μmol/L may indicate ICP, though a negative result does not rule out diagnosis.
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What are the Risks of Intrahepatic Cholestasis of Pregnancy?
Intrahepatic Cholestasis of Pregnancy may pose risks to your unborn child. ICP is associated with increased risks of preterm labor and delivery, meconium staining of the amniotic fluid, respiratory issues, and stillbirth.
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How is Intrahepatic Cholestasis of Pregnancy Treated?
Treatment of Intrahepatic Cholestasis of Pregnancy includes the medication Ursodeoxycholic acid (UDCA), also known as Actigall or Ursodiol, and early delivery. UDCA has been proven safe for both parent and baby, and improves symptoms for the majority of patients. There is less evidence to show a possible improvement in fetal outcomes, however no studies have been large enough to show a definitive answer as to whether stillbirth risk is reduced. It is unlikely that we will ever have such data. Early delivery typically occurs in weeks 36-39, depending on the severity of ICP.
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