Lorente Sara, Montoro Miguel A
Unidad de Gastroenterología y Hepatología. Hospital San Jorge de Huesca. Huesca. España.
Gastroenterol Hepatol. 2007 Nov;30(9):541-7. doi: 10.1157/13111695.
Intrahepatic cholestasis of pregnancy (ICP) is a reversible cholestatic liver disease that may develop during the second or third trimester of pregnancy and resolves rapidly after delivery. The chief complaint is pruritus. Serum liver tests reveal moderate cholestasis with increased levels of bile salts (> or = 10 micromol/l) and aminotransferases. The pathogenesis of ICP is multifactorial. Potential contributors include a genetic predisposition interacting with the effects of estrogen and progesterone metabolites on bile secretory mechanisms, as well as environmental factors. ICP may cause fetal distress, with stillbirths or premature deliveries, leading to increased perinatal morbidity and mortality. Several drugs have been used for ICP treatment. The available evidence suggests that the most effective therapy is ursodeoxycholic acid, since this drug improves pruritus and liver function tests without maternal or fetal toxicity.
妊娠期肝内胆汁淤积症（ICP）是一种可逆性胆汁淤积性肝病，可在妊娠中期或晚期发病，产后迅速缓解。主要症状为瘙痒。血清肝功能检查显示中度胆汁淤积，胆汁盐（≥10微摩尔/升）和转氨酶水平升高。ICP的发病机制是多因素的。潜在因素包括遗传易感性与雌激素和孕激素代谢产物对胆汁分泌机制的影响相互作用，以及环境因素。ICP可能导致胎儿窘迫、死产或早产，从而增加围产期发病率和死亡率。已有多种药物用于ICP的治疗。现有证据表明，最有效的治疗药物是熊去氧胆酸，因为该药可改善瘙痒症状和肝功能检查结果，且无母体或胎儿毒性。
