Intrahepatic cholestasis of pregnancy

Question 1

what is intrahepatic cholestasis of pregnancy (a.k.a. obstetric cholestasis) associated with?

Answer 1

an increased risk of premature birth

recurrence is 45-90% in subsequent pregnancies

Question 2

what are the features of intrahepatic cholestasis of pregnancy?

Answer 2

1. pruritus - may be intense, typical worse palms, soles and abdomen
2. clinically detectable jaundice occurs in around 20%
3. raised bilirubin seen in >90%

Question 3

what is the management of Intrahepatic cholestasis of pregnancy?

Answer 3

1. induction of labour at 37-38 weeks
2. ursodeoxycholic acid
3. vitamin K supplementation