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Intrahepatic cholestasis of pregnancy (Green-top Guideline No. 43)

Published: 9 August 2022

This guideline summarises the evidence regarding the diagnosis, and the maternal and fetal risks of intrahepatic cholestasis of pregnancy (ICP), previously called obstetric cholestasis.

Summary

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).


Version history

The first edition of this guideline was published in 2006; the second edition was published in 2011 (as Obstetric Cholestasis). This is the third edition of this guideline, published in 2022. Next review due: 2026.

Developers’ declarations of interest

Available on request.

 

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