ICP Flashcards
(20 cards)
What is intrahepatic cholestasis of pregnancy (ICP)?
A liver disorder in pregnancy characterized by intense pruritus and elevated bile acids, typically in the second half of pregnancy.
When does ICP usually present?
In the second and/or third trimesters of pregnancy.
What is the hallmark symptom of ICP?
Severe itching (pruritus), especially on the palms and soles, often worse at night.
Is there a rash in ICP?
No, pruritus occurs without a skin rash.
What are other common symptoms of ICP?
Anorexia, epigastric discomfort, steatorrhea, and dark urine (less common).
How can ICP affect sleep?
Severe pruritus may cause sleep deprivation.
What is the impact of steatorrhea in ICP?
It can cause fat-soluble vitamin deficiencies, especially vitamin K.
What complication can result from vitamin K deficiency in ICP?
Increased risk of postpartum hemorrhage.
What are fetal complications when bile acids >40 µmol/L?
Increased risk of preterm labor.
What happens when bile acids exceed 100 µmol/L?
Increased risk of fetal death.
What other fetal complications are seen in ICP?
Meconium-stained amniotic fluid and neonatal respiratory distress.
Is ICP a clinical or laboratory diagnosis?
It is a clinical diagnosis, but lab tests are used to exclude other causes.
What test confirms ICP?
Total serum bile acids >10 µmol/L.
What are the expected LFT findings in ICP?
↑ ALT, ↑ AST, normal or mildly elevated bilirubin, normal GGT.
What imaging is used in ICP workup?
Ultrasound of the liver and biliary tree to exclude other causes like gallstones.
Which viral serologies are tested in ICP evaluation?
Hepatitis A, B, C, CMV, and EBV.
What autoimmune markers are tested to rule out other liver diseases?
Antimitochondrial antibodies and antismooth muscle antibodies.
What is the first-line treatment for ICP?
Ursodeoxycholic acid to reduce pruritus and improve liver function.
When is delivery typically recommended in ICP?
After 37 weeks of gestation, based on symptom severity and bile acid levels.
What happens to ICP after delivery?
The condition resolves postpartum.
