intrahepatic cholestasis of pregnancy 3

Intrahepatic Cholestasis of Pregnancy (ICP) Description

Intrahepatic Cholestasis of Pregnancy, also known as ICP, is a liver disorder that occurs during the second half of pregnancy. This condition affects the normal flow of bile in the liver, leading to a buildup of bile acids in the body.

Key Characteristics:

• Affects the liver's ability to transport bile properly
• Causes a build-up of bile acids in the body
• Typically develops in late pregnancy (second half)
• Can increase risk for problems such as preterm birth, stillbirth, and heavy bleeding after birth

Symptoms May Include:

• Dark urine
• Pale poo
• Yellowing of the skin and whites of the eyes (jaundice), although this is less common

ICP is a reversible condition that can be managed with medical treatment. It's essential for pregnant women to seek medical attention if they experience any symptoms or concerns related to ICP.

References: [3] Mar 16, 2023 - Intrahepatic Cholestasis of Pregnancy is a liver disorder that occurs during pregnancy. This condition affects the normal flow of bile. [5] May include: dark urine, pale poo, yellowing of the skin and whites of the eyes (jaundice), but this is less common. [7] ICP causes a build-up of bile acids in your body. Bile acids are made in your liver ... [9] Intrahepatic cholestasis of pregnancy (ICP) is characterized by maternal pruritus (itch) and liver dysfunction, with raised total serum bile acid ...

Intrahepatic Cholestasis of Pregnancy (ICP) Signs and Symptoms

Intrahepatic cholestasis of pregnancy is a liver condition that can occur during late pregnancy, causing severe itching. The symptoms of ICP are crucial to recognize early on for the well-being of both mother and baby.

Main Symptom: Severe Itching The primary symptom of intrahepatic cholestasis of pregnancy is intense itching, which can be mild or very severe [4]. This itching usually begins on the abdomen, back, arms, and legs, but can spread to other areas as well. The itching can be so severe that it disrupts daily life.

Other Symptoms In addition to severe itching, women with ICP may experience:

• Nausea
• Dark urine
• Light gray or pale brown stool
• Extreme tiredness
• Decreased appetite
• Pain in the abdomen

These symptoms are not unique to intrahepatic cholestasis of pregnancy and can be caused by other conditions. However, if you're experiencing severe itching, especially during late pregnancy, it's essential to consult your healthcare provider for further investigation.

Risk Factors Women carrying multiples, those who have had IVF treatment, and women with prior liver conditions may be at a higher risk of developing intrahepatic cholestasis of pregnancy [9]. If you fall into one of these categories, inform your healthcare provider about your risk factors.

Early recognition and management of ICP are crucial to prevent complications for both mother and baby. Consult your healthcare provider if you're experiencing severe itching or any other symptoms mentioned above.

References: [3] The gallbladder stores the bile. The hormones your body releases during pregnancy change the way the gallbladder works. This may cause bile to slow or stop flowing. Bile builds up in the liver and spills into the bloodstream. The main symptom of cholestasis of pregnancy is severe itching. [4] September 27, 2021 - Intrahepatic cholestasis of pregnancy ... food. But in ICP, the bile acids build up in your body instead. The most common symptom of ICP is itching, which can be mild or very intense.... [5] What are the symptoms of cholestasis of pregnancy? · Nausea. · Dark urine. · Light gray or pale brown poop. · Extreme tiredness. · Decreased appetite. · Pain in the ... [9] March 16, 2023 - The flow of bile acids is significantly reduced and leads to the bile acids building up in the blood stream.

Intrahepatic cholestasis of pregnancy (ICP) can be diagnosed through various diagnostic tests. Here are some of the key tests used to diagnose ICP:

• Total Serum Bile Acid (TSBA) test: This is a blood test that measures the level of bile acids in the blood. Elevated levels of TSBA are a hallmark of ICP [1, 4, 5].
• Liver Function Tests (LFTs): These tests assess how well the liver is functioning and can be elevated in cases of ICP [8, 9].
• Blood tests: Blood tests may also include measuring levels of cholic acid and chenodeoxycholic acid, which are types of bile acids that can be elevated in ICP [4].
• Physical examination: A physical examination by a healthcare provider can also help diagnose ICP, particularly if the patient is experiencing pruritus (itching) [5].

It's worth noting that serum bile acid testing is considered the most accurate way to diagnose ICP, and does not require fasting [1].

Treatment Options for Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a condition that requires prompt treatment to alleviate symptoms and prevent complications. While there are no definitive cures, various treatments can help manage the condition.

• Ursodeoxycholic acid (UDCA): This medication is commonly prescribed to treat ICP. UDCA helps lower the levels of bile acids in the blood, which can reduce itching and other symptoms.
• Oral antihistamines: These medications may be used to provide symptom relief, although their effectiveness in reducing itching has not been extensively studied.

Important Considerations

It is essential to note that ICP can cause significant complications for both mother and baby if left untreated. Therefore, prompt medical attention is crucial to prevent potential harm.

• Early delivery: In severe cases of ICP, early delivery may be necessary to ensure the health and safety of both mother and baby.
• Monitoring: Regular monitoring by a healthcare provider is essential to track the progression of the condition and make informed decisions about treatment.

References

[4] May 22, 2024 - Your provider may also order a prothrombin time test to see how well your blood clots or an ultrasound to look at your bile ducts and liver. Healthcare providers use a medication called ursodeoxycholic acid (UDCA, ursodiol or Actigall®) to treat cholestasis of pregnancy. [7] Once the diagnosis of intrahepatic cholestasis of pregnancy (ICP) is confirmed, immediate treatment is necessary, and the primary goal of therapy is to decrease the risk of perinatal morbidity and mortality and to alleviate maternal symptoms. Ursodeoxycholic acid (UDCA) is the drug of choice ... [9] Prevalence of intrahepatic cholestasis of pregnancy in Chile. Ann Intern Med. 1978 Apr. 88(4):487-93. [QxMD MEDLINE Link]. Laifer SA, Stiller RJ, Siddiqui DS, Dunston-Boone G, Whetham JC. Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy.

Please consult a healthcare professional for personalized advice and guidance on managing ICP.

Differential Diagnosis of Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that occurs during pregnancy, characterized by pruritus and an elevation in serum bile acid concentrations. The differential diagnosis of ICP includes several conditions that can present with similar symptoms.

Conditions to Consider:

• Skin diseases: Certain skin conditions such as dermatitis, eczema, and psoriasis can cause pruritus and may be mistaken for ICP.
• Gallstones (Cholelithiasis): Gallstones can cause biliary obstruction leading to elevated serum bile acids, which may mimic the symptoms of ICP.
• Hepatitis in Pregnancy: Hepatitis during pregnancy can present with elevated liver enzymes and pruritus, making it a differential diagnosis for ICP.

Key Points:

• The diagnosis of ICP is mainly clinical and based on the presence of maternal pruritis, predominantly of the palms and soles [7].
• The prevalence of differential diagnosis was 2% in one study, with ICP suspected in more than 50% of cases in the third trimester of pregnancy [8].

References:

• Bacq Y. (2014) Diagnosis of Intrahepatic Cholestasis of Pregnancy [3]
• Pusl T. (2007) The differential diagnosis of intrahepatic cholestasis of pregnancy with pruritus and elevation of serum bile acid levels only includes skin diseases and specific dermatoses of the palms and soles [5]