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ICP, otherwise known as Obstetric Cholestasis (OC), refers to a specific liver condition in which the normal flow of bile is impaired in a woman's body resulting severe itching and more rarely, jaundice. Although ICP has been reported as early as a few weeks pregnant, it is more common for it to begin in the third trimester, when hormone concentrations are at their highest levels.
The figure for the percentage of women for whom ICP will recur in future pregnancies is still somewhat debated, but some sources claim it to be as high as 90%. ICP is also referred to as choleastais of pregnancy and pruritus gravidarum.
There is still much to be learned about the exact causes of ICP and it's manifestation, but researchers are currently investigating genetic, hormonal and environmental factors. There has been some research that indicate a particular gene mutation in some ICP patients, but much is yet to be defined.
Overall, 1 to 2 pregnancies in 1000 are affected by ICP. Women carrying multiples and those who have had previous liver damage may be more likely to develop ICP. The incidence of ICP also shows a striking geographical pattern, with a higher prevalence in Scandanavia and South America.
The highest rates of ICP are noted in Chile, specifically in the Araucanian Indians, where as many as 28% women are affected. Mothers and sisters of patients of ICP are also at higher risk of developing the condition, proving that there is a definite genetic predisposition.
Symptoms of ICP can vary in severity and type, but the most common ones include:
Less common symptoms include:
ICP poses several risks that are of great concern. ICP is associated with an increased risk for infant stillbirth, premature labor, fetal distress, and hemorrhaging in both mother and child.
Despite the possible outcomes of ICP, proper treatment for ICP provides a great degree of reduction in both fetal risk and maternal symptoms. The two most important factors in the treatment of ICP are reducing the bile acids in the bloodstream and delivering the mother as early as lung maturiy will allow, often at 36 or 37 weeks gestation. In cases where bile acids do not respond to treatment, it may be necessary to deliver earlier than lung maturity to protect the child from the possibility of stillbirth.
Ursodeoxycholic Acid (UDCA), also known as Actigall or Urso is currently the front-line medication for the treatment of ICP. UDCA is a naturally occurring bile acid that improves liver function and helps reduce total bile acid concentration in the bloodstream.
Republished from Itchy Moms, an Online Resource For ICP Sufferers.
Copyright © Itchy Moms. Permission to republish granted to Pregnancy.org, LLC.
