We report a kindred of Anglo-Celtic descent, among whom many members present with ICP, gallstones or cholestasis related to use of oral contraception. [ncbi.nlm.nih.gov]

• Painter

  View Article PubMed Google Scholar Painter JN, Savander M, Sistonen P, Lehesjoki AE, Aittomaki K: A known polymorphism in the bile salt export pump gene is not a risk allele for intrahepatic cholestasis of pregnancy. [ojrd.biomedcentral.com]

• Clay-Colored Stool

  Jaundice and Intrahepatic cholestasis of pregnancy (ICP) The increased build-up of bilirubin leads to jaundice, dark colored urine and pale white clay colored stool. This may be seen in very few severe cases of ICP. [news-medical.net]

• Jaundice

  Jaundice and Intrahepatic cholestasis of pregnancy (ICP) The increased build-up of bilirubin leads to jaundice, dark colored urine and pale white clay colored stool. This may be seen in very few severe cases of ICP. [news-medical.net]

  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]

  Intrahepatic cholestatic jaundice of pregnancy presents as pruritus, abnormal liver biochemistry and increased serum bile acids. CASE PRESENTATION: A Sri Lankan girl presented with recurrent episodes of jaundice. [ncbi.nlm.nih.gov]

• Recurrent Jaundice

  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]

  Description DEFINITION Intrahepatic cholestasis of pregnancy ICP also known as Obstretic cholestasis or recurrent jaundice of pregnancy or Pruritus gravidarum, is a cholestatic disorder characterized by pruritus,elevated serum aminotransferases and bile [flipper.diff.org]

  Ben-hamou Recurrent jaundice caused by recurrent hypere-mesis gravidarum Gut, 25 (1984), pp. 1414-1415 [26.] AFG De Patger, Henegouwen GP Van Berge, Bokkel Huinink JA Ten, K.H. Brandt Familial bening recurrent intrahe-patic cholestasis. [elsevier.es]

  Keywords Bile Acid Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Intrahepatic Cholestasis Serum Bile Acid Disease name and synonyms Intrahepatic cholestasis of pregnancy Obstetric cholestasis Recurrent jaundice of pregnancy Pruritus gravidarum [ojrd.biomedcentral.com]

• Scleral Icterus

  Scleral icterus and jaundice were observed at 27 weeks. Elevated bile acid levels confirmed a diagnosis of intrahepatic cholestasis of pregnancy, and ursodeoxycholic acid therapy was initiated. [ncbi.nlm.nih.gov]

• Pruritus

  Pruritus improved in 75/98 (76.5%) patients, and totally disappeared before delivery in 25/98 (25.5%). [ncbi.nlm.nih.gov]

  “The pruritus of cholestasis is relieved by an opiate antagonist: is this pruritus a centrally mediated phenomenon?” Hepatology 23 ( 5): 1280-1282. 3. Arrese, M., Macias, R. I., et al. (2008). [rosslab.neurobio.pitt.edu]

• 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]

  These are called excoriations and may be complicated with bacterial infections as well. The itching sites may sometimes bleed due to excessive scratching. Due to chronic itching the nails of the patient may also appear shiny and smooth. [news-medical.net]

  Related Signs and Symptoms In addition to severe itching, the signs and symptoms of intrahepatic cholestasis of pregnancy may include: Jaundice Rash due to scratching (excoriations) Loss of appetite (anorexia) Fatigue Light colored and greasy stools that [dermatology.about.com]

  Secondary skin lesions like excoriation marks may be observed, narrating a pruritic tale. [e-ijd.org]

• Dark Urine

  Associated manifestations include fatigue, loss of appetite, dark urine and pale stools. Hepatomegaly is also a common finding. Between episodes patients show no symptoms and the interval between attacks varies from months to years. [orpha.net]

  Although itching, which may be mild or severe and is typically on hands and feet (although it can be anywhere on the body) is the main symptom of ICP, other things to look out for are dark urine and pale stools. [goodtoknow.co.uk]

  Less common symptoms include dark urine, pale stools, pain under your ribs or shoulder blade, and some women get jaundiced. [community.babycenter.com]

  Signs and Symptoms ICP has been linked to adverse maternal and fetal outcomes Main symptoms: Puritus - without evidence of skin lesions (Itching, particularly on the hands and feet (often is the only symptom noticed ) Dark urine color,steatorrhoea,Fatigue [slideshare.net]

• Anisocytosis

  Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. [ncbi.nlm.nih.gov]

After 2-3 weeks of treatment, ALT levels decreased by more than 50% of base line in 67/86 (77.9%) patients and normalized in 34/86 (39.5%), and TBA concentrations decreased in 28/81 (34.6%). Only one patient stopped the treatment before delivery. [ncbi.nlm.nih.gov]

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]

Data were compared between good (n = 21) (disease-free before 1 year old) and poor prognosis groups (n = 19). Good prognosis patients had a higher urinary THBA proportion than poor prognosis patients [25.89% (3.45-76.73%) vs. 1.93% (0.05-48.90%)]. [ncbi.nlm.nih.gov]

Prognosis The prognosis is generally good with a tendency for a reduction in the frequency of attacks with age. However, progression from BRIC to PFIC and cirrhosis has been reported in the literature, indicative of a clinical continuum. [orpha.net]

Maternal prognosis is usually good but can result in adverse fetal outcome. [e-ijd.org]

However, it may worsen malabsorption of vitamin K and does not alter liver function or fetal prognosis [12]. [peridocs.com]

OBJECTIVES: The etiology of intrahepatic cholestasis of pregnancy (ICP) involves environmental, hormonal and genetic factors. [ncbi.nlm.nih.gov]

The etiology is unclear, but it believed to have genetic, hormonal, and environmental components. Possible fetal complications include meconium staining of amniotic fluid, preterm labor, and unexplained sudden intrauterine demise. [benthamscience.com]

This article will review the epidemiology, clinical features, pregnancy complications, and treatment for ICP. [benthamscience.com]

Epidemiology/Incidence : 0.3-0.5% among the general population with up to 15% incidence in Latin American countries. Incidence also increased in Hepatitis C infection (6-16%). [smfm.org]

Summary Epidemiology The prevalence of BRIC is unknown. Clinical description The first cholestatic episode can occur at any age but onset within the first two decades of life is most common. [orpha.net]

Epidemiology ICP varies geographically world wide but high incidence has been reported in the following countries: Araucanian Indian descent in Chile and Boliva - 6%-27.6% Sweden 1%-1.5% Women of Indian-Asian/Pakistain-Asian Orign - 1-2-1.5% Lower elsewhere [slideshare.net]

In this review, we will describe recent advances in the understanding of this condition with a particular emphasis on how aspects of genetic and reproductive hormone involvement in pathophysiology have been elucidated. [ncbi.nlm.nih.gov]

PRESENTATION: Here, we report for the first time a 24-year Japanese case of severe ICP diagnosed by typical symptoms, serum biochemical analysis, and treated with the administration of ursodeoxycholic acid which improved cholestasis and liver injury and prevented [ncbi.nlm.nih.gov]

Prevention : There are no preventative therapies or interventions available. Management: Preconception counseling: Risk of recurrence is between 50-60% in subsequent pregnancies after an affected index pregnancy. [smfm.org]

The difficulty in predicting and preventing unanticipated fetal death near term drives the obstetrician's desire to deliver infants before 38 weeks. [neoreviews.aappublications.org]