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.
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).
This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers, and prior to the emergence of COVID-19.
This is the third edition of this guideline.
Please note that the information provided in this update will be considered for update by the RCOG Guidelines Committee 3 years after publication, with an intermediate assessment of the need to update 2 years after publication.
Developers’ declarations of interest
Available on request.