Your pregnancy: intrahepatic cholestasis of pregnancy

WHILE most pregnancies are celebratory moments, some are truly difficult times for women who may have underlying medical conditions or develop complications within the nine-month period.One condition, though not very common in our population, is intrahepatic cholestasis of pregnancy (ICP), which, according to obstetrician gynaecologist (ObGyn) Dr Jordan Hardie, is a medical disorder of pregnancy in which there is an increase in the production of bile salts.While the exact cause is unknown, Dr Hardie explained that research has shown that genetic, hormonal and environmental factors are risk factors for the development of this condition, and patients with a family history of intrahepatic cholestasis of pregnancy are more likely to develop this condition.The ObGyn said patients normally experience symptoms of severe itching in the second and third trimester, and pointed out that the itching is normally worse at night.Dr Hardie said ICP normally resolves in the mother with treatment and delivery; however, it can significantly affect the foetus, increasing the risk of intra-uterine demise, meconium stained liquor (when the foetus passes stool before delivery), and neonatal respiratory distress syndrome.Dr Hardie said treatment is focused on controlling symptoms, reducing the concentration of bile salts in the blood, and delivery at the safest possible time.“The drug of choice is Ursdeocholic Acid to reduce the bile salts. Patients may also be given antihistamines to reduce the symptoms. Timing of delivery is dependent on the severity of the condition affecting the mother, risk of prematurity to the infant, and other foetal complications like intrauterine demise and meconium stained liquor,” he said.He also added that ICP may recur in as many as 60-70 per cent of subsequent pregnancies in patients who have had it in a previous pregnancy.Dr Hardie said individuals seeking further clarity on the issue may email him at

drjhardieobgyn@gmail.com.