Intrahepatic cholestasis of pregnancy, or ICP, is a rare condition that affects approximately 0.5% of pregnant women. Usually, the condition develops during the third trimester and will stop after delivery. If you had ICP during a previous pregnancy, your chances of getting it again are about 50%.
Intrahepatic cholestasis of pregnancy occurs when there is an increased amount of bile in the bloodstream, because of a backup in the liver. When the bile builds up in the bloodstream, it leaves the skin with a severe itching sensation.Symptoms
The most common symptom of ICP is an intense itch that begins on the palms of the hands and soles of the feet. The itch will then spread to other areas of the body. Because the skin becomes so itchy, most women will scratch it and a rash will develop. Another common symptom of ICP is jaundice, or a yellowing of the skin. Although not all women will experience all characteristics of the condition, other possible symptoms include fatigue, dark colored urine, greasy bowel movements, urinary tract infections and abdominal pain.Tests and Diagnosis
When a pregnant woman complains of severe itching, jaundiced skin or other complications, the doctor will usually test for intrahepatic cholestasis of pregnancy. To determine if ICP is present, a blood test will be performed. The blood test will be screening for increased bile levels and liver enzymes. Occasionally, an ultrasound or liver biopsy might be required to fully diagnose the condition.Treatment
The intense itching of intrahepatic choleostasis of pregnancy can be controlled with anti-itch medications, antihistamines, oatmeal baths, oral steroids or skin creams. In more severe cases, doctors may choose to prescribe medications that help bile secrete properly. Women with ICP will be monitored closely during pregnancy to ensure that the developing fetus is healthy. Because the fetal liver is not able to remove bile acides from the blood properly, the mother's liver takes over for the growing baby. In a woman with ICP, the bile levels are already elevated and the levels can cause damage to the fetus's liver. There is an increased risk of preterm delivery, stillbirth and meconium aspiration at birth for a woman with intrahepatic cholestasis of pregnancy.
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