Intrahepatic cholestasis of pregnancy

Regular maternal serum bile acid testing is recommended for symptomatic women, because management decisions are based on the degree of bile acid elevation, and bile acid concentrations can change rapidly throughout a pregnancy.[79]European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL clinical practice guidelines on the management of liver diseases in pregnancy. J Hepatol. 2023 Sep;79(3):768-828. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext http://www.ncbi.nlm.nih.gov/pubmed/37394016?tool=bestpractice.com ​The frequency of monitoring typically increases closer to birth (and is recommended at least weekly from 32 gestational weeks). Concurrent liver function testing is recommended to monitor severity and progress of the disease.

There is no definitive evidence that supports a particular prenatal fetal monitoring strategy. Prenatal cardiotocography and ultrasound scans might be of reassurance at the time of the test, but the adverse outcomes of ICP are not predictable based on standard investigations beyond liver biochemistry.