When present, it increases the incidence of acute hepatic failure. [patient.info]

In this study only four patients (12.5%) presented with CBD stones. [saudijgastro.com]

Clinical presentation Preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy share similar presentations and differentiating between the three entities can be difficult. All present late in pregnancy and can have similar clinical features. [wjgnet.com]

The presenting symptom of OC is pruritus, which is more noticeable at night. Researchers are not sure why this is. Other symptoms include dark urine, steatorrhea and, less commonly, jaundice. [rcm.org.uk]

Headaches are common, and altered sensorium may be noted on presentation as well. [glowm.com]

• Liver Disorder in Pregnancy

  It occurs in 3% to 10% of all pregnancies. Several disorders contribute to liver disease in pregnancy ( Box 1 ). [clevelandclinicmeded.com]

• Jaundice

  JAUNDICE DURING PREGNANCY ... - - 17 1) Incidence of jaundice durip. g pregnancy 17 2) Classification of jaundice during pregnancy 17 3) Frequency distribution of different diseases causing jaundice during pregnancy ... ... '. 20 4) Review of literature [books.google.de]

  because of jaundice of 2 weeks'. .. [nejm.org]

  Intrahepatic cholestasis of pregnancy Also known as recurrent cholestasis of pregnancy, obstetric cholestasis, cholestasis of pregnancy, recurrent jaundice of pregnancy, cholestatic jaundice of pregnancy, idiopathic jaundice of pregnancy, prurigo gravidarum [dermcoll.edu.au]

  […] of unknown cause but associated with high estrogen levels. intrahepatic cholestasis of pregnancy a type of intrahepatic cholestasis sometimes seen during the third trimester of pregnancy, characterized by severe itching, hepatomegaly, and sometimes jaundice [medical-dictionary.thefreedictionary.com]

  Jaundice is a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of the eyes. The medical term for jaundice in babies is neonatal jaundice. [nhs.uk]

• Recurrent Jaundice

  Synonym(s): cholestasis of pregnancy, recurrent jaundice of pregnancy. intrahepatic cholestasis of pregnancy Abbreviation: ICP A complication of approx. 1% of pregnancies in which elevated levels of pregnancy hormones cause obstruction to bile flow within [medical-dictionary.thefreedictionary.com]

  ALTHOUGH there have been numerous reports in the European literature on a syndrome of recurrent jaundice in late pregnancy we have found only sparse reference to it in the American literature. [nejm.org]

  Intrahepatic cholestasis of pregnancy Also known as recurrent cholestasis of pregnancy, obstetric cholestasis, cholestasis of pregnancy, recurrent jaundice of pregnancy, cholestatic jaundice of pregnancy, idiopathic jaundice of pregnancy, prurigo gravidarum [dermcoll.edu.au]

  Recurrent jaundice caused by recurrent hyperemesis gravidarum. Abstract The existence of jaundice induced by hyperemesis gravidarum is controversial. [gut.bmj.com]

• Pruritus

  […] intrahepatic cholestasis of pregnancy intrahepatic cholestasis with centrilobular bile staining without inflammatory cells or proliferation of mesenchymal cells; clinically characterized by pruritus and icterus; of unknown cause but associated with high [medical-dictionary.thefreedictionary.com]

  These are deposited within the skin, causing intense pruritus. [flipper.diff.org]

  […] on pruritus as compared to UDCA monotherapy [ 42 ]. [ojrd.biomedcentral.com]

  Pruritus (itching) is a common symptom of pregnancy, affecting around 20% of women. [3] The majority of times, itching is a minor annoyance caused by changes to the skin, especially that of the abdomen. [en.wikipedia.org]

  Kenyon AP, et al. (2001) Pruritus may precede abnormal liver function tests in pregnant women with obstetric cholestasis: a longitudinal analysis. BJOG 108 : 1190-2. [rcm.org.uk]

• Excoriation

  There is no rash but the skin may show scratch marks (excoriations) or become yellow (jaundiced). This condition typically develops late in pregnancy and resolves within days after the baby is born. [dermcoll.edu.au]

• Dark Urine

  The following signs and symptoms may be present in cases of cholestasis of pregnancy: intense itching, especially on the palms of the hands and soles of the feet dark urine light-colored feces jaundice, giving the whites of the eyes, skin and tongue a [medicalnewstoday.com]

  Other symptoms include dark urine, steatorrhea and, less commonly, jaundice. Itching can be intense or mild and there appears to be no correlation between intensity of itch with increased fetal risk. [rcm.org.uk]

  Other signs such as pale stools or dark urine may indicate a problem with your liver, including OC/ICP. Your doctor can diagnose OC/ICP from blood tests called liver function tests (LFTs) and a serum bile salt test. [britishlivertrust.org.uk]

The underlying disorder can have a significant effect on morbidity and mortality in both mother and fetus, and a diagnostic workup should be initiated promptly. [clevelandclinicmeded.com]

What is the treatment for ICP? Despite the possible outcomes of ICP, proper treatment provides a great degree of reduction in both fetal risk and maternal symptoms. [liverfoundation.org]

Treatment Treatment may not be necessary if cholestasis is mild and occurs late in pregnancy. Treatment normally aims to relieve symptoms, mainly the itching, and to prevent potential complications. [medicalnewstoday.com]

Thus, early recognition, treatment, and timely delivery are imperative. [emedicine.medscape.com]

While jaundice isn't usually a cause for concern, it's important to determine whether your baby needs treatment. [nhs.uk]

TREATMENT The primary objective of pharmacologic treatment in ICP is to alleviate maternal symptoms and improve fetal outcome. Many drug agents have been used in the treatment of ICP. [flipper.diff.org]

Jaundice in pregnancy carries a grave prognosis for both the fetus and the mother, and is responsible for 10% of maternal deaths. The present study analyzes the causes and the fetomaternal outcome in pregnancies affected with jaundice. [ijrcog.org]

Prognosis Hyperemesis gravidarum is usually a reversible condition with no permanent damage to the liver and almost never fatal. [wjgnet.com]

Maternal prognosis is good and symptoms resolve rapidly after delivery,accompanied by normalization of serum liver test. ICP recurs during subsequent pregnancies in 45-70% with varying severity of recurrent episodes. [flipper.diff.org]

There is generally a favourable prognosis for both mother and baby. Pre-eclamptic liver disease and HELLP See the separate HELLP Syndrome article for further details. [patient.info]

Pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): subsequent pregnancy outcome and long-term prognosis. Am J Obstet Gynecol. 1995;172(1 Pt 1):125–9. 25. [aafp.org]

The etiology of this syndrome is unknown, but the clinical and laboratory findings are sufficiently distinctive to separate it from other causes of jaundice. [nejm.org]

The cause of ICP is unknown but is thought to be multifactorial with genetic,hormonal and environmental involvement.Family clustering and varying incidence in different geographic regions speaks strongly for a genetic etiology of ICP. [flipper.diff.org]

Etiology and pathogenesis The etiology of ICP is not completely understood and is still under discussion. Genetic and hormonal factors, but also environmental factors may contribute to the pathogenesis of ICP [ 1 ]. [ojrd.biomedcentral.com]

ICP has no clear etiology, and it is believed to be a multifactorial disorder with environmental, hormonal, and genetic contributions. [emedicine.medscape.com]

Etiology of cirrhosis in pregnancy is similar to that in the nonpregnant state and commonly includes alcohol and viral hepatitis C and B. Cirrhosis can affect ovulation and cause infertility. [clevelandclinicmeded.com]

Acute fatty liver of pregnancy Epidemiology It is a rare condition with an incidence of 5 in 100,000 pregnancies. [ 8 ] Acute fatty liver of pregnancy (AFLP) tends to occur in late pregnancy. [ 3 ] Risk factors include first pregnancies, pre-eclampsia [patient.info]

EPIDEMIOLOGY The incidence of ICP varies widely with geographical location and ethnicity. 1 to 2 pregnancies in 1000 are affected by cholestasis. it is most common in South America, particularly in Chile, where the early reports described an overall incidence [flipper.diff.org]

[…] findings remains to be fully elucidated. [17, 18] A study by Abu-Hayyeh et al found that sulfated progesterone metabolites are a prognostic indicator for ICP and can help predict onset of ICP and distinguish it from benign pruritus gravidarum. [19] Epidemiology [emedicine.medscape.com]

Epidemiology ICP has been observed in almost all ethnic groups, but there is relevant geographical variation in the incidence of ICP [ 1, 4 ]. [ojrd.biomedcentral.com]

It typically arises in the third trimester of pregnancy, although it has been reported as early as 13 weeks' gestation. 18 – 20 The pathophysiology of intrahepatic cholestasis of pregnancy remains poorly understood. 19 Pruritus alone occurs in 80 percent [aafp.org]

[…] microvesicular steatosis cannot be detected as well as the more common macrovesicular fatty change, in which imaging is very sensitive. 123 Although the exact mechanism of liver injury still is unknown, great advances have been made in understanding the pathophysiology [glowm.com]

Pathophysiology Affected individuals have a defect involving the excretion of bile salts, which leads to increased serum bile acids. [emedicine.medscape.com]

There are no clinical markers that predict the course of a pregnancy and the pathophysiologic mechanisms are not always understood, but knowledge and management of the preconception liver disease and efficacious pre-pregnancy and prenatal care are essential [clevelandclinicmeded.com]

Treatment normally aims to relieve symptoms, mainly the itching, and to prevent potential complications. [medicalnewstoday.com]

The gallbladder or its bile ducts can become blocked, preventing excretion of bilirubin into the intestine. Bilirubin will then back up into the liver and then into the bloodstream. [medbroadcast.com]

Many of these women are sexually active and do not take effective measures to prevent pregnancy. [clevelandclinicmeded.com]

There’s no real way to prevent newborn jaundice. During pregnancy, you can have your blood type tested. [healthline.com]

 Infusion of concentrated glucose solution may be required to treat or prevent hypoglycemia. 26.  Prompt delivery  The route should be guided by obstetric indications. [slideshare.net]