Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri.
Semin Liver Dis. 2021 Jan;41(1):103-108. doi: 10.1055/s-0040-1722264. Epub 2021 Jan 20.
Intrahepatic cholestasis of pregnancy (ICP) is a common disorder in the second half of pregnancy characterized by pruritus and elevated serum bile acids (BAs) with spontaneous resolution after delivery. ICP carries a risk of adverse effects on the fetus which correlates with the degree of BA elevation. ICP occurs in genetically susceptible women as the reproductive hormones increase during pregnancy. Ursodeoxycholic acid is still considered the first-line treatment for ICP though it is of unproven benefit in preventing adverse effects on the fetus. Fetal complications, such as stillbirth, increase with gestational age, so preterm delivery is generally performed in cases of severe ICP, defined as BA levels above 40 μmol/L. ICP may recur in future pregnancies and is associated with an increased risk for future hepatobiliary, immune mediated, and cardiovascular diseases. Children born of mothers with ICP have normal development but may have a risk for subsequent metabolic disease.
妊娠肝内胆汁淤积症（ICP）是妊娠后半期的一种常见疾病，其特征为瘙痒和血清胆汁酸（BAs）升高，分娩后可自行缓解。ICP 会对胎儿产生不良影响，其程度与 BA 升高的程度相关。ICP 发生在遗传易感的女性中，因为妊娠期间生殖激素增加。熊去氧胆酸仍被认为是 ICP 的一线治疗药物，尽管它在预防对胎儿的不良影响方面没有被证实有效。胎儿并发症，如死胎，随胎龄增加而增加，因此对于严重的 ICP（定义为 BA 水平高于 40μmol/L）通常会进行早产。ICP 可能在未来妊娠中复发，并与未来肝胆、免疫介导和心血管疾病的风险增加相关。母亲患有 ICP 的儿童发育正常，但可能有后续代谢疾病的风险。
