Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentRisk FactorsComplicationsCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Risk Factors
Complications
Coping
Intrahepaticcholestasisof pregnancy (ICP), commonly referred to simply as cholestasis of pregnancy, is a liver condition that most often occurs in late pregnancy.
Symptoms may includeitchy hands and feetandyellow eyes. ICP poses risks to the fetus, so early diagnosis and monitoring are important.
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Also Known AsObstetric cholestasisIntrahepatic cholestasis of pregnancyICP
Also Known As
Obstetric cholestasisIntrahepatic cholestasis of pregnancyICP
Signs / Symptoms of Cholestasis of Pregnancy
The most prominent symptom of ICP is extremeitching. Itching may occur all over the body, but it most commonly affects the palms of the hands and soles of the feet.
Other symptoms include:
While cholestasis is a liver condition that affects all genders and can occur at any age, ICP is a temporary complication of pregnancy. Symptoms usually resolve soon after giving birth.
When to Call a Healthcare ProviderICP can lead to complications, like premature birth, stillbirth, and fetal distress, so be sure to let your healthcare provider know right away if you experience itching or any other symptoms.
When to Call a Healthcare Provider
ICP can lead to complications, like premature birth, stillbirth, and fetal distress, so be sure to let your healthcare provider know right away if you experience itching or any other symptoms.
Estrogen and progesterone also play a known role in the development of ICP. These hormones can affect the liver’s ability to move bile acids. Estrogen and progesterone naturally rise late in pregnancy, which may be why ICP most commonly develops in the third trimester.
People carrying multiples and who have undergone IVF treatment are at higher risk of developing ICP.In addition, ICP occurs more commonly in colder months in some countries, although researchers have not identified why.
People with ICP most often present with pruritis (itchy skin). Healthcare providers usually begin with a skin examination to determine whether the itching could be related to a skin condition, like dermatitis oreczema. A rash does not accompany ICP-related itching.
When bile acids total 10 micromoles per liter and above, a diagnosis of ICP is confirmed.Increasedtransaminasesand directbilirubinare also present in many cases. Your healthcare provider may also screen forhepatitis Csince ICP is higher among people with this liver condition.
Ursodeoxycholic acid (UDCA) is a medication that is used to treatpruritis. Though the Food and Drug Administration (FDA) does not list ICP as an indication for using UDCA, it is considered an effective treatment for the pruritis and liver function.
A meta-analysis of randomized controlled trials found that UDCA is safe and effective at reducing pruritis symptoms, improving liver function, and improving maternal and fetal outcomes.
Vitamin K deficiencyoften accompanies ICP. That’s because the underproduction of bile can interfere with the body’s ability to absorb fat-soluble vitamins, like vitamin K. If a deficiency is present, it should be treated before delivery to prevent postpartum hemorrhage.
ICP is the most common liver condition that affects pregnancy. It occurs at a rate of 0.2% to 2% of pregnancies.The rate is as high as 15% in some Latin American countries.
Risk factors for developing ICP include:
ICP is a serious condition of pregnancy that can impact maternal and fetal health. As the maternal bile acids reach the placenta, they accumulate in the amniotic fluid, leading to complications in the fetus. The higher the serum bile acid levels, the greater the risk for fetal complications.
Possible complications of ICP include:
Maternal symptoms usually resolve shortly after giving birth. The long-term maternal prognosis is good, although a study did find an increased risk for a later diagnosis ofgallstones, livercirrhosis, and hepatitis C.
Being diagnosed with ICP can be unnerving. If you have been diagnosed with ICP, be sure to follow your healthcare provider’s instructions. If you have been given medication, take it regularly. Be sure to ask lots of questions about your options and what to expect.
Most people recover fully, shortly after giving birth. You may find support groups for people with pregnancy complications or those who have given birth early to be helpful.
Search online for groups or ask your healthcare provider or nurse if they can suggest any. If you have a friend or family member who has experienced a pregnancy complication or premature birth, they may be able to provide valuable support as well.
A Word From Verywell
Cholestasis of pregnancy is a rare but serious complication of pregnancy. If you have been diagnosed with ICP, you will want to work closely with your healthcare provider to manage your condition. You will likely need to take medication to reduce bile acids. You may also need to give birth earlier than expected.
If you experience any symptoms of ICP—especially the most common symptom of itching skin—tell your healthcare provider. Diagnosing and managing ICP is the only way to reduce the risk of complications. Remember, most of the time ICP resolves after giving birth, and people do not usually go on to have long-term complications from it.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Cholestasis of pregnancy.American Liver Foundation.Intrahepatic cholestasis of pregnancy (ICP).Lee RH, Mara Greenberg, Metz TD, Pettker CM.Society for maternal-fetal medicine consult series #53: intrahepatic cholestasis of pregnancy.American Journal of Obstetrics and Gynecology. 2021;224(2):B2-B9. doi:10.1016/j.ajog.2020.11.002Kong X, Kong Y, Zhang F, Wang T, Yan J.Evaluating the effectiveness and safety of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy.Medicine (Baltimore). 2016;95(40):e4949. doi:10.1097/md.0000000000004949Wood A, Livingston E, Hughes B, Kuller J.Intrahepatic cholestasis of pregnancy: a review of diagnosis and management.Obstet Gynecol Surv. 2018;73(2):103-109. doi:10.1097/ogx.0000000000000524Milkiewicz P, Elias E, Williamson C, Weaver J.Obstetric cholestasis: May have serious consequences for the fetus, and needs to be taken seriously.BMJ : British Medical Journal. 2002;324(7330):123. doi:10.1136/bmj.324.7330.123Pillarisetty LS, Sharma A.Pregnancy intrahepatic cholestasis. In:StatPearls. StatPearls Publishing; 2024.Marschall HU, Wikström Shemer E, Ludvigsson JF, Stephansson O.Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population-based cohort study.Hepatology. 2013;58(4):1385-1391. doi:10.1002/hep.26444
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Cholestasis of pregnancy.American Liver Foundation.Intrahepatic cholestasis of pregnancy (ICP).Lee RH, Mara Greenberg, Metz TD, Pettker CM.Society for maternal-fetal medicine consult series #53: intrahepatic cholestasis of pregnancy.American Journal of Obstetrics and Gynecology. 2021;224(2):B2-B9. doi:10.1016/j.ajog.2020.11.002Kong X, Kong Y, Zhang F, Wang T, Yan J.Evaluating the effectiveness and safety of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy.Medicine (Baltimore). 2016;95(40):e4949. doi:10.1097/md.0000000000004949Wood A, Livingston E, Hughes B, Kuller J.Intrahepatic cholestasis of pregnancy: a review of diagnosis and management.Obstet Gynecol Surv. 2018;73(2):103-109. doi:10.1097/ogx.0000000000000524Milkiewicz P, Elias E, Williamson C, Weaver J.Obstetric cholestasis: May have serious consequences for the fetus, and needs to be taken seriously.BMJ : British Medical Journal. 2002;324(7330):123. doi:10.1136/bmj.324.7330.123Pillarisetty LS, Sharma A.Pregnancy intrahepatic cholestasis. In:StatPearls. StatPearls Publishing; 2024.Marschall HU, Wikström Shemer E, Ludvigsson JF, Stephansson O.Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population-based cohort study.Hepatology. 2013;58(4):1385-1391. doi:10.1002/hep.26444
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Cholestasis of pregnancy.American Liver Foundation.Intrahepatic cholestasis of pregnancy (ICP).Lee RH, Mara Greenberg, Metz TD, Pettker CM.Society for maternal-fetal medicine consult series #53: intrahepatic cholestasis of pregnancy.American Journal of Obstetrics and Gynecology. 2021;224(2):B2-B9. doi:10.1016/j.ajog.2020.11.002Kong X, Kong Y, Zhang F, Wang T, Yan J.Evaluating the effectiveness and safety of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy.Medicine (Baltimore). 2016;95(40):e4949. doi:10.1097/md.0000000000004949Wood A, Livingston E, Hughes B, Kuller J.Intrahepatic cholestasis of pregnancy: a review of diagnosis and management.Obstet Gynecol Surv. 2018;73(2):103-109. doi:10.1097/ogx.0000000000000524Milkiewicz P, Elias E, Williamson C, Weaver J.Obstetric cholestasis: May have serious consequences for the fetus, and needs to be taken seriously.BMJ : British Medical Journal. 2002;324(7330):123. doi:10.1136/bmj.324.7330.123Pillarisetty LS, Sharma A.Pregnancy intrahepatic cholestasis. In:StatPearls. StatPearls Publishing; 2024.Marschall HU, Wikström Shemer E, Ludvigsson JF, Stephansson O.Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population-based cohort study.Hepatology. 2013;58(4):1385-1391. doi:10.1002/hep.26444
Cleveland Clinic.Cholestasis of pregnancy.
American Liver Foundation.Intrahepatic cholestasis of pregnancy (ICP).
Lee RH, Mara Greenberg, Metz TD, Pettker CM.Society for maternal-fetal medicine consult series #53: intrahepatic cholestasis of pregnancy.American Journal of Obstetrics and Gynecology. 2021;224(2):B2-B9. doi:10.1016/j.ajog.2020.11.002
Kong X, Kong Y, Zhang F, Wang T, Yan J.Evaluating the effectiveness and safety of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy.Medicine (Baltimore). 2016;95(40):e4949. doi:10.1097/md.0000000000004949
Wood A, Livingston E, Hughes B, Kuller J.Intrahepatic cholestasis of pregnancy: a review of diagnosis and management.Obstet Gynecol Surv. 2018;73(2):103-109. doi:10.1097/ogx.0000000000000524
Milkiewicz P, Elias E, Williamson C, Weaver J.Obstetric cholestasis: May have serious consequences for the fetus, and needs to be taken seriously.BMJ : British Medical Journal. 2002;324(7330):123. doi:10.1136/bmj.324.7330.123
Pillarisetty LS, Sharma A.Pregnancy intrahepatic cholestasis. In:StatPearls. StatPearls Publishing; 2024.
Marschall HU, Wikström Shemer E, Ludvigsson JF, Stephansson O.Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population-based cohort study.Hepatology. 2013;58(4):1385-1391. doi:10.1002/hep.26444
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