小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 瘙痒
- 不伴皮疹的皮肤抓痕
其他诊断因素
- 轻度黄疸
危险因素
- ICP 家族史
- ICP 既往史
- 丙型肝炎感染史
- 胆石症
- 慢性乙型肝炎感染
- 多胎妊娠
- 辅助生殖技术
- 种族
诊断性检查
首要检查
- 胆汁酸
- 肝功能检测
需考虑的检查
- 凝血指标
- 丙型肝炎病毒学
- 肝脏和胆道超声检查
- 全血细胞计数
- 自身抗体检测
治疗流程
妊娠期瘙痒（血清胆汁酸浓度 <10 μmol/L）
轻度的妊娠期肝内胆汁淤积症（血清胆汁酸浓度 ≥10 [或非空腹情况下 ≥19] 且 <40 μmol/L）
中度的妊娠期肝内胆汁淤积症（血清胆汁酸浓度 ≥40 且 <100 μmol/L）
重度的妊娠期肝内胆汁淤积症（血清胆汁酸浓度 ≥100 μmol/L）
撰稿人
作者
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
利益声明
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
利益声明
CO is an author of a number of references cited in this topic. She consults for Mirum Pharmaceuticals.
鸣谢
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.
利益声明
RHD and DJ declare that they have no competing interests.
同行评议者
Frank Lammert, MD
Director
Department of Internal Medicine II
Professor Internal Medicine
Saarland University Hospital
Homburg
Germany
利益声明
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
利益声明
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
利益声明
VB declares that he has no competing interests.
鉴别诊断
- 急性病毒性肝炎
- HELLP 综合征
- 急性妊娠期脂肪肝
更多 鉴别诊断指南
- 妊娠期肝内胆汁淤积症
- 妊娠期肝内胆汁淤积症
更多 指南患者教育信息
丙型肝炎：何为丙型肝炎？
更多 患者教育信息
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