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 23 November 2017

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News

Intrahepatic cholestasis of pregnancy and fetal complication rates

There is no increase in fetal risk in patients with intrahepatic cholestasis of pregnancy if with bile acid levels are less than 40 mol/L, find physicians in the August issue of Hepatology.

News image

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Intrahepatic cholestasis of pregnancy (ICP) is characterized by pruritus in the second half of pregnancy. It results in increased risk to the fetus.

In this study, physicians from Sweden determined the incidence and fetal complication rates in ICP, and defined groups at increased risk.

The team screened 45,485 pregnancies in a defined region of Sweden for ICP.

They defined ICP as otherwise unexplained pruritus of pregnancy in combination with fasting serum bile acid levels 10 mol/L.

The team found that pruritus was reported by 2.1% of women, and ICP was diagnosed in 1.5%.
ICP was diagnosed in 1.5% of women.
Hepatology

Using logistic regression analyses, the team determined that that the probability of fetal complications increased by 1% to 2% per additional mol/L of serum bile acids.

The physicians also found that fetal complications did not occur until bile acid levels were > 40 mol/L.

Gallstone disease and a family history of ICP were significantly more prevalent in the group of ICP patients with higher bile acid levels.

Dr Anna Glantz and colleagues concluded, "We found an incidence of ICP in our population of 1.5%".

"From complication rates recorded prospectively, we could define a mild (81%) and a severe (19%) form of ICP, the latter with bile acid levels 40 mol/L".

"No increase in fetal risk was detected in ICP patients with bile acid levels <40 mol/L, and we propose that these women be managed expectantly, which would significantly reduce the costs of medical care".

Hepatology 2004; 40(2): 467–74
19 August 2004

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