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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]
Cholestasis is a condition where the flow of bile from the liver to the duodenum is impaired. [1] The two basic distinctions are: [1] obstructive type of cholestasis, where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and
[1] [2] Patients observe these symptoms and seek medical advice from healthcare professionals. Because most people are not diagnostically trained or knowledgeable, they typically describe their symptoms in layman's terms, rather than using specific medical terminology. This list is not exhaustive.
The RANZCOG training program is a six-year structured post-graduate program which leads to certification as a Fellow of RANZCOG (FRANZCOG). FRANZCOG status is the only post-graduate qualification which leads to recognition as a specialist obstetrician & gynaecologist in Australia and New Zealand.
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Women with velamentous cord insertion may not experience any symptoms throughout pregnancy. [16] During delivery, there may be slow or abnormal fetal heart rate patterns [3] [10] [19] and there may be excessive bleeding or hemorrhage, particularly if the fetal vessels rupture. [1] [7] [9] [22]
Symptoms include shortness of breath in various positions and/or with exertion, fatigue, pedal edema, and chest tightness. Risk factors associated with the development of this complication include maternal age over 30 years, multi gestational pregnancy, family history of cardiomyopathy, previous diagnosis of cardiomyopathy, pre-eclampsia ...
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
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