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Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum, [1] is a medical condition in which cholestasis occurs during pregnancy. [2] It typically presents with itching and can lead to complications for both mother and fetus. [2]
Neonatal cholestasis can present in newborn infants within the first few months of life. [1] The incidence of neonatal cholestasis is approximately 1 in 2,500 term births. [5] While neonatal cholestasis can present from a number of pathologic causes, 35-40% of neonatal cholestasis cases are caused by biliary atresia. [3]
Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
Intrahepatic cholestasis of pregnancy (ICP) is an acute cause of cholestasis that manifests most commonly in the third trimester of pregnancy. [15] It affects 0.5–1.5% of pregnancies in Europe and the US and up to 28% in women of Mapuche ethnicity in Chile. [60]
This causes an accumulation of bilirubin in the blood (hyperbilirubinemia), leading to the symptoms of jaundice. [ citation needed ] If the neonatal jaundice is not resolved with simple phototherapy , other causes such as biliary atresia , Progressive familial intrahepatic cholestasis , bile duct paucity, Alagille syndrome , alpha 1-antitrypsin ...
Progressive familial intrahepatic cholestasis (PFIC) is a group of familial cholestatic conditions caused by defects in biliary epithelial transporters. The clinical presentation usually occurs first in childhood with progressive cholestasis. This usually leads to failure to thrive, cirrhosis, and the need for liver transplantation. [citation ...
Prognosis is good, and treatment of this syndrome is usually unnecessary. Most patients are asymptomatic and have normal lifespans. [5] Some neonates present with cholestasis. [5] Hormonal contraceptives and pregnancy may lead to overt jaundice and icterus (yellowing of the eyes and skin). [citation needed]
Acute fatty liver of pregnancy is a rare life-threatening complication of pregnancy that occurs in the third trimester or the immediate period after delivery. [1] It is thought to be caused by a disordered metabolism of fatty acids by mitochondria in the fetus, caused by long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency. [2]
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