Intrahepatic Cholestasis of Pregnancy Clinical Presentation

Updated: Jan 14, 2019
  • Author: Fidelma B Rigby, MD; Chief Editor: Ronald M Ramus, MD  more...
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Presentation

History

Intrahepatic cholestasis of pregnancy (ICP) is characterized by pruritus that usually occurs in the second or third trimester; however, ICP may occur as early as the first trimester. ICP-related pruritus without a rash may affect all areas of the body but characteristically starts in the soles of the feet and palms of the hands and progresses to the trunk and face. [44] Pruritus associated with ICP is often worse at night and the pruritus may be so severe that it can affect the patient’s quality of life, even leading to suicidal ideation. [16] Steatorrhea and vitamin K deficiency may also occur due to fat malabsorption. [44] If the vitamin K deficiency is not corrected by the time of delivery, a postpartum hemorrhage may ensue.

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Physical

ICP is characterized by profound itching often beginning with the palms of the hands and soles of the feet without evidence of a rash.

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