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Intrahepatic cholestasis of pregnancy

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Last updated:1st Jun 2022
Intrahepatic cholestasis of pregnancy - Royal College of Obstetricians and Gynaecologists (RCOG)

This guideline summarises the evidence regarding the diagnosis, and the maternal and fetal risks of intrahepatic cholestasis of pregnancy (ICP), previously called obstetric cholestasis. It provides guidance regarding the different care options available. These should be considered in conjunction with the wishes of the woman, as part of shared and informed decision-making.

While some high quality randomised controlled trials in ICP have now been completed, many publications do not have such a rigorous design, and this limits the ability to provide detailed evidence-based recommendations for specific aspects of care. Areas of uncertainty are highlighted along with recommendations for future research in this field.

ICP is defined as: mild (peak bile acids 19–39 micromol/L), moderate (peak bile acids 40–99 micromol/L) and severe (peak bile acids 100 micromol/L or more).

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