7.1 Intrahepatic cholestasis of pregnancy (IHCP)

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Presents in pregnant patients with pruritus and increased bile salts. This is the most frequent pregnancy-related liver disease. Pathogenesis is based on a dysfunction of bile transporters in patients with a genetic predisposition. From the 26th week onwards, the patient develops pruritus without a rash and there is a significant increase in serum bile salts.

The prognosis is usually benign for the mother. It gives rise to 20% mortality in the child. There is a risk if the bile salts are >40 micromol/l. The disease disappears immediately after induction of labor. Recurrence may occur in a subsequent pregnancy. Treatment consists of ursodeoxycholic acid (15mg/kg/day) and induction of pregnancy.

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