Marschall Hanns-Ulrich
a Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, S-41345 Gothenburg, Sweden.
Expert Rev Gastroenterol Hepatol. 2015;9(10):1273-9. doi: 10.1586/17474124.2015.1083857. Epub 2015 Aug 27.
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and elevated bile acids and/or transaminases. ICP is associated with an increased risk of adverse perinatal outcomes for the fetus and the later development of hepatobiliary disease for the mother. Bile acids should be monitored throughout pregnancy since fetal risk is increased at serum bile acids >40 µmol/l. Management of ICP consists of treatment with ursodeoxycholic acid, which reduces pruritus. Early elective delivery is common practice but should be performed on an individualized basis as long as strong evidence supporting this practice is lacking. Mothers should be followed-up for normalization of liver function tests 6-12 weeks after delivery. Future research in large-scale studies is needed to address the impact of ursodeoxycholic acid and early elective delivery on fetal outcome.
妊娠期肝内胆汁淤积症（ICP）是妊娠期最常见的肝脏疾病，其特征为妊娠晚期（妊娠中期和晚期）出现无法解释的瘙痒，以及胆汁酸和/或转氨酶升高。ICP与胎儿不良围产期结局风险增加以及母亲日后发生肝胆疾病有关。由于血清胆汁酸>40µmol/l时胎儿风险增加，因此在整个孕期都应监测胆汁酸。ICP的治疗包括使用熊去氧胆酸，它可减轻瘙痒。早期选择性分娩是常见做法，但在缺乏有力证据支持的情况下，应根据个体情况进行。产后6 - 12周应对母亲进行随访，以观察肝功能检查是否恢复正常。需要开展大规模研究以探讨熊去氧胆酸和早期选择性分娩对胎儿结局的影响。
