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Obstetric cholestasis |
Hépato-Gastro. Volume 18, Number 3, 277-82, Mai-Juin 2011, Mini-revue
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 Résumé
Texte intégral
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Author(s) : Sophie Hillaire |
Summary : Intrahepatic cholestasis of pregnancy (ICP) is a specific liver disorder, occurring during the third trimester of pregnancy, and characterized by maternal pruritus, elevated serum bile acids and transaminases levels, improving rapidly after delivery. The prevalence of ICP varies widely ranging from 0.01 to 30%. ICP is a disease involving genetic, hormonal and environmental factors and frequently recurs in case of subsequent pregnancies. ICP carries a risk of foetal complications including prematurity, asphyxia events, and meconium staining of the amniotic fluid. Intrauterine foetal death (IUFD) occurs in 1 to 2% of cases and can not be predicted. Systematic delivery at 37-38 weeks gestation has been recommended to prevent IUFD but its benefits remains to be demonstrated. Treatment with ursodeoxycholic acid improves pruritus and maternal biochemical markers and reduces the risk of prematurity. ICP is more common in patients with biliary or liver diseases (hepatitis C, lithiasis, cirrhosis…). |
Keywords : pruritus, pregnancy, intrauterine death, bile acids, ursodeoxycholic acid, hepatocanalicular transport protein |
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