Fetal complications due to intrahepatic cholestasis of pregnancy
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Patrik Šimják
, Antonín Pařízek, Libor Vítek
, Andrej Černý , Karolína Adamcová , Michal Koucký , Martin Hill , Michaela Dušková and L’uboslav Stárka
Abstract
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder of pregnancy. Diagnosis is based on the clinical picture, particularly the presence of pruritus with a deterioration of liver function tests, and typically elevated serum levels of total bile acids. ICP manifests in the second half of pregnancy, predominantly during the third trimester. Symptoms of the disease resolve spontaneously after delivery. Etiology is still not fully understood. Genetic defects in specific transport proteins, elevated levels of sex hormones, and various environmental factors are thought to play a role in the development of this disorder. Although practically benign for the pregnant woman, ICP represents a serious threat to the fetus. It increases the risk of preterm delivery, meconium excretion into the amniotic fluid, respiratory distress syndrome, and sudden intrauterine fetal death. Identifying fetuses at risk of ICP complications remains challenging. The ideal obstetrical management of ICP needs to be definitively determined. The aim of this review is to summarize the current knowledge on fetal complications of ICP and describe management options for their prevention.
Conflict of interest statement
Author’s conflict of interest disclosure:
None declared.
Funding:
Supported by Internal Grant Agency of the Ministry of Health of the Czech Republic, (Grant/Award Number: ‘IGA MZCR NT 12211-5’).
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar