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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
A postpartum disorder or puerperal disorder is a disease or condition which presents primarily during the days and weeks after childbirth called the postpartum period.The postpartum period can be divided into three distinct stages: the initial or acute phase, 6–12 hours after childbirth; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can ...
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The only current recommended and most effective treatment is delivery of the baby, as the signs and symptoms diminish and gradually disappear following the delivery of the placenta. Prompt delivery is the only viable option in cases with multiorgan dysfunction or multiorgan failure , haemorrhage and considerable danger to the fetus.
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.
The signs and symptoms of amniotic fluid embolism can vary from one individual to another but involve systemic involvement of multiple organ systems. Often, a patient may present with a cough due to the release of bradykinin , an inflammatory marker released during times of pain and which causes an anaphylactoid reaction . [ 4 ]
Additional symptoms may vary based on the cause of neonatal cholestasis. For example, if a patient’s symptoms are caused by a choledochal cyst, they may present with abdominal pain, vomiting, and a palpable abdominal mass. [4] Patients with alpha-1 antitrypsin deficiency may present with hepatomegaly and elevated liver enzymes. [9]