Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum, is a medical condition in which cholestasis occurs during pregnancy. It typically presents with itching and can lead to complications for both mother and baby. Pruritus (itching) is a common symptom of pregnancy, affecting around 23% of women. The majority of times, itching is a minor annoyance caused by changes to the skin, especially that of the abdomen. However, there are instances when itching may be a symptom of ICP. Although typically noticed on the palms of the hands and the soles of the feet, the itching can occur anywhere on the body. ICP occurs most commonly in the third trimester, but can begin at any time during the pregnancy. Most women with this condition present in the third trimester (although it can present as early as seven weeks) with itching without a rash. Typically, the itching is localized to the palms of the hands and soles of the feet, but can be anywhere on the body. Hallmarks of ICP include the following symptoms: Most common: Itching, in particular but not limited to that of the palms of the hands and soles of the feet, without presence of a rash Itching that is more noticeable in the evening Darker urine Less common: Lighter stools Increased clotting time (due to possibly associated vitamin K deficiency) Fatigue Increased nausea Decrease in appetite Jaundice (less than 10% of women) Upper right quadrant pain Not all ICP sufferers have all of the above symptoms. The causes of intrahepatic cholestasis of pregnancy are still not fully understood, but are thought to be caused through a combination of genetics, hormones and environment. Hormones, environmental and genetic factors are all thought to contribute to the condition. ICP commonly occurs in the third trimester at the time when hormone levels are at their highest. Twin and triplet pregnancies, which are associated with higher hormone levels, show a higher incidence of ICP.