www.rcog.org.uk [Accessed March 2015] RCOG. Obstetric Cholestasis ... Obstetric Cholestasis (OC) affects 0.7% of pregnancies in the UK. Intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis is a rare form of reversible cholestasis occurring in the second half of pregnancy and is one of the specific dermatoses of pregnancy, along with pemphigoid gestationis, polymorphic eruption of pregnancy, and atopic eruption of pregnancy. Skin disease in pregnancy. Obstetric Cholestasis (OC) is a multifactorial condition of pregnancy characterised by intense pruritus in the absence of a skin rash, with abnormal liver function tests (LFTs), which resolves following birth. 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. Obstetric cholestasis. Type: Guidance . Obstetric cholestasis has also been found to run in some families. 2012a. Royal College of Obstetricians and Gynaecologists, Green-top guideline, 43. www.rcog.org.uk [Accessed July 2019] Tyler KH. Obstetric Cholestasis Diagnosis and Management Clinical Guideline V2.1 Page 2 of 12 1. The clinical importance of obstetric cholestasis lies in the potential fetal risks, which may include spontaneous preterm birth, iatrogenic If you have obstetric cholestasis during one pregnancy, there is a high risk that it may happen again in a future pregnancy. What is obstetric cholestasis? For more information, see the CKS topic on Itch - widespread. Exclude obstetric cholestasis by checking LFTs (raised AST/ALT; alkaline phosphatase is increased in normal pregnancy and so an unreliable marker of cholestasis in pregnancy). Intrahepatic cholestasis of pregnancy is a liver disorder that occurs in pregnant women. 28 ICP has a high recurrence rate – as high as 70% – in subsequent pregnancies. Intrahepatic cholestasis of pregnancy (ICP) is a potentially serious liver disorder that can develop in pregnancy. 1.4. The condition causes bile acids and other harmful substances to build up in the liver, which can then “leak” into the bloodstream (6, 7). In ICP, the bile acids do not flow properly and build up in your body instead. Clin Obstet Gynecol 58(1):119-24 Vaughan Jones S, Ambros-Rudolph C, Nelson-Piercy C. 2014. Obstetric cholestasis (also known as intrahepatic cholestasis of pregnancy/ICP) is the most common cause of itch that presents without a rash in pregnancy. 2015. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. Obstetric cholestasis is a multifactorial condition that is characterised by abnormal liver function tests, jaundice and intense pruritis (typically affecting the palms and soles of the feet). Clinical Knowledge Summaries - CKS (Add filter) 01 April 2020 The main cause of itch without an associated rash in pregnancy is obstetric cholestasis. Cholestasis can result in inadequate vitamin K and coagulopathy inducing a haemorrhage. The disease usually presents in the third trimester and is associated with an increased risk of intrauterine death and premature delivery. Cholestasis is an impairment of bile formation and/or bile flow, which may clinically present with fatigue, pruritus, dark urine, pale stools and, in its most overt form, jaundice and signs of fat soluble vitamin deficiencies. Source: Clinical Knowledge Summaries - CKS. See the section on in the CKS topic on for further information. The main cause of itch without an associated rash in pregnancy is obstetric cholestasis. The cause of impaired bile flow in obstetric cholestasis is currently unclear but is thought to involve a combination of hormonal, genetic, and environmental factors. Itching usually occurs on the hands and feet but can also affect other parts of the body. What is intrahepatic cholestasis? Bilirubin deposition most commonly occurs in the skin and the sclerae and becomes apparent on physical exam when bilirubin levels reach > 2 mg/dL. With cholestasis, the flow of bile is impaired at some point between the liver cells (which produce bile) and the duodenum (the first segment of the small intestine). Obstetric cholestasis (also known as intrahepatic cholestasis of pregnancy) is an uncommon but serious liver disorder that can develop during pregnancy. Also known as intrahepatic cholestasis of pregnancy (ICP), obstetric cholestasis is a multifactorial condition affecting 0.7% of pregnancies (1.2-1.5% of women of Indian-Asian or Pakistani descent). 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