How to Cite
1.
Espinoza Artavia AL, Vílchez León M, Webb Webb K. Intrahepatic cholestasis in pregnancy. Rev.méd.sinerg. [Internet]. 2019Jun.1 [cited 2024Nov.23];4(6):14 - 23. Available from: https://revistamedicasinergia.com/index.php/rms/article/view/196
Abstract
Intrahepatic cholestasis of pregnancy is the most common pregnancy-specific liver disease and typically occurs during the second trimester or third trimester of pregnancy. It has a multifactorial etiology, which will depend on genetic characteristics and hormonal influences, among other variables. It is characterized by pruritus and alterations of laboratory parameters, such as elevation of bile acids and alteration of liver function tests. It is still poorly understood and because the guidelines have not yet been standardized, it has different diagnostic criteria. The treatment pillar consists of ursodeoxycholic acid. It is usually benign for women with rapid resolution after childbirth, but is associated with adverse perinatal complications, including preterm birth and intrauterine fetal death. There is still much to explore and determine regarding this complex pathology, in order to reach a consensus among the different guides and to obtain the best recommendations for the population worldwide.
Keywords
pregnancy. cholestasis. intrahepatic. bile acids and salts. ursodeoxycholic acid. fetal mortality.
References
1. Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines. Eur J Obstet Gynecol Reprod Biol. 2018 Diciembre; 231: 180-187. https://doi.org/10.1016/j.ejogrb.2018.10.041
2. Chivers S, Williamson C. Intrahepatic cholestasis of pregnancy. Obstet Gynaecol Reprod Med. 2018 Julio; 28(7): 215-217. https://doi.org/10.1016/j.ogrm.2018.06.003
3. Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014 Julio; 124(1): 120-133. https://doi.org/10.1097/AOG.0000000000000346
4. Dixon PH, Williamson C. The pathophysiology of intrahepatic cholestasis of pregnancy. Clin Res Hepatol Gastroenterol. 2016 Abril; 40(2): 141-153. https://doi.org/10.1016/j.clinre.2015.12.008
5. Henderson CE, Shah RR, Gottimukkala S, Ferreira KK, Hamaoui A, Mercado R. Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy. AmJ Obstet Gynecol. 2014 Setiembre; 211(3): 189–196. https://doi.org/10.1016/j.ajog.2014.03.058
6. Gabzdyl EM, Schlaeger JM. Intrahepatic cholestasis of pregnancy: a critical clinical review. J Perinat Neonatal Nurs. 2015 Enero; 29(1): 41-50. https://doi.org/10.1097/JPN.0000000000000077
7. Cappell MS. Obtetrics Normal and Problem Pregnancies. 7th ed. Philadelphia: Elsevier; c2016 Abril. Hepatic Disorders During Pregnancy; p.1008-1011.
8. Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy: Recent advances. Clin Dermatol. 2016 Mayo-Junio; 34(3): 327-334. https://doi.org/10.1016/j.clindermatol.2016.02.004
9. Floreani A, Gervasi MT. New Insights on Intrahepatic Cholestasis of Pregnancy. Clin Liver Dis. 2016 Febrero; 20(1): 177-189. https://doi.org/10.1016/j.cld.2015.08.010
10. Lindor KD, Lee RH. Intrahepatic cholestasis of pregnancy [Internet]. Waltham, MA: Uptodate; 2019 [citado 2019 Marzo 16]. Disponible en: https://www.uptodate.com/contents/intrahepatic-cholestasis-of-pregnancy/print
11. Cunningham FG. Normal reference ranges for laboratory values in pregnancy [Internet]. Waltham, MA: Uptodate; 2019 [citado 2019 Abril 03]. Disponible en: https://www.uptodate.com/contents/normal-reference-ranges-for-laboratory-values-in-pregnancy/print
12. Tram TT, Ahn J, Reau NS. ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016 Febrero; 111(2): 176–194. https://doi.org/10.1038/ajg.2015.430
13. Palmer KR, Xiahoua L, Mol BW. Management of intrahepatic cholestasis in pregnancy. Lancet. 2019 Febrero; 393(10174): 853-854. http://dx.doi.org/10.1016/S0140-6736(18)33186-6
14. Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. Lancet . 2019 Marzo; 393(10174): 899-909. https://doi.org/10.1016/S0140-6736(18)31877-4
15. Liu X, Landon MB, Chen Y, Cheng W. Perinatal outcomes with intrahepatic cholestasis of pregnancy in twin pregnancies. J Matern Fetal Neonatal Med. 2015 Setiembre; 29(13): 2176-2181. https://doi.org/10.3109/14767058.2015.1079612
16. Wikström Shemer EA, Stephansson O, Thuresson M, Thorsell M, Ludvigsson JF, Marschall HU. Intrahepatic cholestasis of pregnancy and cancer, immunemediated and cardiovascular diseases: A population-based cohort study. J Hepatol. 2015 Agosto; 63(2): 456–461. https://doi.org/10.1016/j.jhep.2015.03.010
17. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. US medical eligibility criteria for contraceptive use. 2016 Julio. http://dx.doi.org/10.15585/mmwr.rr6503a1
2. Chivers S, Williamson C. Intrahepatic cholestasis of pregnancy. Obstet Gynaecol Reprod Med. 2018 Julio; 28(7): 215-217. https://doi.org/10.1016/j.ogrm.2018.06.003
3. Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014 Julio; 124(1): 120-133. https://doi.org/10.1097/AOG.0000000000000346
4. Dixon PH, Williamson C. The pathophysiology of intrahepatic cholestasis of pregnancy. Clin Res Hepatol Gastroenterol. 2016 Abril; 40(2): 141-153. https://doi.org/10.1016/j.clinre.2015.12.008
5. Henderson CE, Shah RR, Gottimukkala S, Ferreira KK, Hamaoui A, Mercado R. Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy. AmJ Obstet Gynecol. 2014 Setiembre; 211(3): 189–196. https://doi.org/10.1016/j.ajog.2014.03.058
6. Gabzdyl EM, Schlaeger JM. Intrahepatic cholestasis of pregnancy: a critical clinical review. J Perinat Neonatal Nurs. 2015 Enero; 29(1): 41-50. https://doi.org/10.1097/JPN.0000000000000077
7. Cappell MS. Obtetrics Normal and Problem Pregnancies. 7th ed. Philadelphia: Elsevier; c2016 Abril. Hepatic Disorders During Pregnancy; p.1008-1011.
8. Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy: Recent advances. Clin Dermatol. 2016 Mayo-Junio; 34(3): 327-334. https://doi.org/10.1016/j.clindermatol.2016.02.004
9. Floreani A, Gervasi MT. New Insights on Intrahepatic Cholestasis of Pregnancy. Clin Liver Dis. 2016 Febrero; 20(1): 177-189. https://doi.org/10.1016/j.cld.2015.08.010
10. Lindor KD, Lee RH. Intrahepatic cholestasis of pregnancy [Internet]. Waltham, MA: Uptodate; 2019 [citado 2019 Marzo 16]. Disponible en: https://www.uptodate.com/contents/intrahepatic-cholestasis-of-pregnancy/print
11. Cunningham FG. Normal reference ranges for laboratory values in pregnancy [Internet]. Waltham, MA: Uptodate; 2019 [citado 2019 Abril 03]. Disponible en: https://www.uptodate.com/contents/normal-reference-ranges-for-laboratory-values-in-pregnancy/print
12. Tram TT, Ahn J, Reau NS. ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016 Febrero; 111(2): 176–194. https://doi.org/10.1038/ajg.2015.430
13. Palmer KR, Xiahoua L, Mol BW. Management of intrahepatic cholestasis in pregnancy. Lancet. 2019 Febrero; 393(10174): 853-854. http://dx.doi.org/10.1016/S0140-6736(18)33186-6
14. Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. Lancet . 2019 Marzo; 393(10174): 899-909. https://doi.org/10.1016/S0140-6736(18)31877-4
15. Liu X, Landon MB, Chen Y, Cheng W. Perinatal outcomes with intrahepatic cholestasis of pregnancy in twin pregnancies. J Matern Fetal Neonatal Med. 2015 Setiembre; 29(13): 2176-2181. https://doi.org/10.3109/14767058.2015.1079612
16. Wikström Shemer EA, Stephansson O, Thuresson M, Thorsell M, Ludvigsson JF, Marschall HU. Intrahepatic cholestasis of pregnancy and cancer, immunemediated and cardiovascular diseases: A population-based cohort study. J Hepatol. 2015 Agosto; 63(2): 456–461. https://doi.org/10.1016/j.jhep.2015.03.010
17. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. US medical eligibility criteria for contraceptive use. 2016 Julio. http://dx.doi.org/10.15585/mmwr.rr6503a1
Downloads
Download data is not yet available.