Review
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 14, 2008; 14(38): 5781-5788
Published online Oct 14, 2008. doi: 10.3748/wjg.14.5781
Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems
Jurate Kondrackiene, Limas Kupcinskas
Jurate Kondrackiene, Limas Kupcinskas, Department of Gastroenterology, Kaunas University of Medicine, Kaunas 50009, Lithuania
Author contributions: Kondrackiene J and Kupcinskas L contributed equally to this work; Kondrackiene J and Kupcinskas L wrote the paper based on results of their own experience and recent literature sources (PubMed, ISI Web of Science) on ICP.
Correspondence to: Jurate Kondrackiene, MD, PhD, Department of Gastroenterology, Kaunas University of Medicine, Eiveniu Street 2, Kaunas 50009, Lithuania. jukond@takas.lt
Telephone: +370-37-326896 Fax: +370-37-326508
Received: April 23, 2008
Revised: June 16, 2008
Accepted: June 23, 2008
Published online: October 14, 2008
Abstract

Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP.

Keywords: Cholestasis of pregnancy; Canalicular ABC transporters; Pruritus; Fetal outcome; Ursodeoxycholic acid