Bile is made by the liver cells.
It is stored and secreted by the gallbladder.
When a person has ICP, the normal flow of bile in thegallbladderis slowed or stopped.
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Symptoms may includeitchy hands and feetandyellow eyes.
ICP poses risks to the fetus, so early diagnosis and monitoring are important.
Symptoms usually resolve soon after giving birth.
Causes
ICP may be brought on by a combination of genetic, hormonal, and environmental factors.
Researchers have found that a mutation in some genes can lead to bile transport dysfunction.
ICP has been known to run in families.
Estrogen and progesterone also play a known role in the development of ICP.
These hormones can affect the livers ability to move bile acids.
Diagnosis
People with ICP most often present with pruritis (itchy skin).
A rash does not accompany ICP-related itching.
Bloodwork is done to check liver function and the level of bile acids in the blood.
Your healthcare provider may also screen forhepatitis Csince ICP is higher among people with this liver condition.
Treatment
Ursodeoxycholic acid (UDCA) is a medication that is used to treatpruritis.
In addition to treatment with medication, it is important to deliver the baby as early as safely possible.
Generally, this is around the 37-week mark because that is when fetal lung maturity occurs.
Vitamin K deficiencyoften accompanies ICP.
Risk Factors
ICP is the most common liver condition that affects pregnancy.
The higher the serum bile acid levels, the greater the risk for fetal complications.
Possible complications of ICP include:
Maternal symptoms usually resolve shortly after giving birth.
If you have been diagnosed with ICP, be sure to follow your healthcare providers instructions.
If you have been given medication, take it regularly.
Be sure to ask lots of questions about your options and what to expect.
Most people recover fully, shortly after giving birth.
Search online for groups or ask your healthcare provider or nurse if they can suggest any.
A Word From Verywell
Cholestasis of pregnancy is a rare but serious complication of pregnancy.
You will likely need to take medication to reduce bile acids.
You may also need to give birth earlier than expected.
If you experience any symptoms of ICPespecially the most common symptom of itching skintell your healthcare provider.
Diagnosing and managing ICP is the only way to reduce the risk of complications.
Cleveland Clinic.Cholestasis of pregnancy.
American Liver Foundation.Intrahepatic cholestasis of pregnancy (ICP).
2021;224(2):B2-B9.
2016;95(40):e4949.
2002;324(7330):123. doi:10.1136/bmj.324.7330.123
Pillarisetty LS, Sharma A.Pregnancy intrahepatic cholestasis.
StatPearls Publishing; 2024.
2013;58(4):1385-1391. doi:10.1002/hep.26444
