Colestasis Intrahepatica del Embarazo: Revisión de tema.

Abstract

Intrahepatic Cholestasis of Pregnancy (ICP) is a liver disorder specific to pregnancy that is characterized by maternal pruritus, which usually develops in the late second or third trimester of pregnancy, with impaired liver function test (including elevated serum bile acids). Clinical signs and symptoms resolve quickly after delivery, however there is a high risk that the disorder will recur in subsequent pregnancies. The etiology for ICP is complex and not fully understood, but it is likely the result of the cholestatic effects of reproductive hormones and their metabolites in genetically susceptible women. ICP is associated with an increased risk of adverse perinatal outcomes and the risk of development of sequelae later in life for the mother, such as hepatobiliary disease. Increases in maternal bile acids >40μmol/L have been shown to correlate with fetal complications such as premature delivery, meconium staining of the amniotic fluid, and fetal death; even more so when the levels of bile acids are above 100μmol/L. The first-line treatment is ursodesoxycholic acid, however, the evidence is in conflict to demonstrate the effectiveness and reduction of both maternal and fetal adverse effects. Elective early delivery is also a common practice but must be performed on an individual basis as there is no strong evidence to support the practice. This review includes etiology, maternal clinical characteristics, diagnosis, maternal and fetal complications and information from the updated evidence on benefits of current management in ICP.