Pregnancy is characterized by various physiological changes and restructuring processes of the female body. Although harmless pregnancy-specific diseases are to be differentiated from this but may also be associated with a risk to the mother or the child.
These comprise the so-called intrahepatic cholestasis of pregnancy (ICP); a liver disease that occurs in some women in late pregnancy. It leads to a temporary decrease in liver function, causing bile acids to accumulation in liver and bloodstream. Elevated serum bile acid concentrations are considered the most sensitive laboratory parameter for diagnosis and monitoring of intrahepatic cholestasis of pregnancy, which is associated with a significantly increased preterm birth rate, increased stillbirth rate and intrapartum "fetal distress". The exact causes of ICP are not yet fully understood, but genetic predisposition, hormonal factors, and environmental conditions play a role in its development.
ICP is subject to significant geographic and ethnic variation. In Europe, the incidence is highest in the Scandinavian countries.
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Literature: Majsterek M, Wierzchowska-Opoka M, Makosz I, Kreczyńska L, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. Bile Acids in Intrahepatic Cholestasis of Pregnancy. Diagnostics (Basel). 2022 Nov 9;12(11):2746. Manzotti C, Casazza G, Stimac T, Nikolova D, Gluud C. Total serum bile acids or serum bile acid profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy. Cochrane Database Syst Rev. 2019 Jul 5;7(7):CD012546.