When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Intrahepatic cholestasis of pregnancy

Last reviewed: 30 Apr 2025
Last updated: 19 Mar 2025

Summary

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • pruritus
  • excoriations without rash
Todos los datos

Otros factores de diagnóstico

  • mild jaundice
Todos los datos

Factores de riesgo

  • family history of ICP
  • previous history of ICP
  • history of hepatitis C infection
  • cholelithiasis
  • chronic hepatitis B infection
  • multifetal pregnancy
  • assisted reproduction
  • ethnicity
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • bile acids
  • liver function tests
Todos los datos

Pruebas diagnósticas que deben considerarse

  • coagulation profile
  • hepatitis C virology
  • liver and biliary tract ultrasound
  • complete blood count
  • autoantibody tests
Todos los datos

Algoritmo de tratamiento

Agudo

gestational pruritus (serum bile acid concentrations <10 micromol/L)

mild intrahepatic cholestasis of pregnancy (serum bile acid concentrations ≥10 [or nonfasting, ≥19] and <40 micromol/L)

moderate intrahepatic cholestasis of pregnancy (serum bile acid concentrations ≥40 and <100 micromol/L)

severe intrahepatic cholestasis of pregnancy (serum bile acid concentrations ≥100 micromol/L)

Colaboradores

Autores

Catherine Williamson, FRCP, FMedSci

Professor of Women’s Health

King’s College London

Honorary Consultant in Obstetric Medicine

Guy’s and St Thomas’ NHS Foundation Trust

London

UK

Divulgaciones

CW is an author of a number of references cited in this topic. She consults for Mirum Pharmaceuticals and GSK and has been reimbursed for her time given to advise on ileal bile acid inhibitors. She has been a member of two Medical Research Council Boards (Public Health and Systems Medicine Board and Public Health Strategy Board) and is on the Scientific Committee of the Society for Endocrinology. CW has grants from NIHR, Diabetes UK, Lauren Page Trust, and ICP Support.

Caroline Ovadia, BMBCh, MA, PhD, MRCOG

Clinical Senior Lecturer in Obstetrics

King’s College London

Honorary Consultant Obstetrician

Guy’s and St Thomas’ NHS Foundation Trust

London

UK

Divulgaciones

CO is an author of a number of references cited in this topic. She has consulted for Mirum Pharmaceuticals.

Agradecimientos

Professor Catherine Williamson and Dr Caroline Ovadia would like to gratefully acknowledge Dr Robert H. Debbs and Dr Derek Jurus, previous contributors to this topic.

Divulgaciones

RHD and DJ declare that they have no competing interests.

Revisores por pares

Frank Lammert, MD

Director

Department of Internal Medicine II

Professor Internal Medicine

Saarland University Hospital

Homburg

Germany

Divulgaciones

FL declares that he has no competing interests.

Ron Librizzi, DO, FACOOG

Director

Maternal Fetal Medicine

Virtua Health System

Associate Professor of Obstetrics and Gynecology

Thomas Jefferson University School of Medicine

Philadelphia

PA

Divulgaciones

RL declares that he has no competing interests.

Vincenzo Berghella, MD, FACOG

Director

Maternal Fetal Medicine

Professor

Obstetrics and Gynecology

Thomas Jefferson University School of Medicine

Philadelphia

PA

Divulgaciones

VB declares that he has no competing interests.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Ovadia C, Seed PT, Sklavounos A, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. Lancet. 2019 Mar 2;393(10174):899-909.Texto completo  Resumen

Girling J, Knight CL, Chappell L, et al. Intrahepatic cholestasis of pregnancy: green-top guideline no. 43 June 2022. BJOG. 2022 Aug 9 [Epub ahead of print].Texto completo  Resumen

Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology. 2004 Aug;40(2):467-74.Texto completo  Resumen

Society for Maternal-Fetal Medicine; Lee RH, Greenberg M, Metz TD, et al. Society for Maternal-Fetal Medicine consult series #53: Intrahepatic cholestasis of pregnancy: replaces consult #13, April 2011. Am J Obstet Gynecol. 2021 Feb;224(2):B2-9.Texto completo  Resumen

European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL clinical practice guidelines on the management of liver diseases in pregnancy. J Hepatol. 2023 Sep;79(3):768-828.Texto completo  Resumen

Walker KF, Chappell LC, Hague WM, et al. Pharmacological interventions for treating intrahepatic cholestasis of pregnancy. Cochrane Database Syst Rev. 2020 Jul 27;7(7):CD000493.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Diferenciales

    • Acute viral hepatitis
    • HELLP syndrome
    • Acute fatty liver of pregnancy
    Más Diferenciales
  • Guías de práctica clínica

    • Pregnancy-related gastrointestinal and liver disease
    • Intrahepatic cholestasis of pregnancy – diagnosis and management: a consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ)​
    Más Guías de práctica clínica
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad