Intrahepatic cholestasis of pregnancy: current clinical and treatment and diagnostic approaches

BACKGROUND: The article is devoted to the current problem of intrahepatic cholestasis of pregnancy. This disease complicates the course of pregnancy, worsens the quality of life of patients and is a predictor of obstetric and perinatal complications. AIM: To analyze clinical features, epidemiology, treatment, and diagnosis of patients with verified intrahepatic cholestasis of pregnancy, to study the relationship between the level of bile acids and the severity of skin itching and the development of complications in newborns. MATERIALS AND METHODS: Using a retrospective analysis technique, medical histories of patients with intrahepatic cholestasis of pregnancy were studied. RESULTS: Verified intrahepatic cholestasis of pregnancy was found to be associated with the age over 30 years old, high baseline body mass index (more 25 kg/m2), and with consecutive pregnancy. Most patients (64%) were diagnosed with intrahepatic cholestasis after 36 weeks of pregnancy. Skin itching is the main clinical symptom of intrahepatic cholestasis of pregnancy, which in most cases (46.7%) was pronounced. Meanwhile, the intensity of itching, depended on the level of bile acids (p = 0.00000000001). There is a relationship between the degree of increased levels of bile acids and the appearance of various respiratory disorders in newborns (p = 0.003). CONCLUSIONS: The topic under consideration will be of interest to specialists in the field of obstetrics and gynecology, gastroenterology, hepatology, and therapy. The issue of diagnosis and treatment of intrahepatic cholestasis of pregnancy requires further study.