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Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a reversible form of cholestasis, specific to pregnancy that usually becomes apparent in the third trimester of pregnancy and disappears after delivery of the baby, and the signs and symptoms of the condition disappear. It is disorder characterized by pruritus (itching) usually on the hands and feet but often on many other parts of the body with onset in the second or third trimester of pregnancy, elevated serum aminotransferases and bile acid levels not attributed to other illnesses. The pruritus may be mild and tolerable for some patients, but may also be very severe and disabling, worsening in the evening.

Despite being historically being thought that ICP increases fetal morbidity (prematurity, meconium, an increased number of caesarian deliveries and antepartum death), there now exists evidence which rule out this association, as these parameters can also be associated to a iatrogenia (a medical cause) of the delivery, with the exception of those cases in which there is an increase in biliary acids In spite of not having sufficient evidence, there does seems to be a greater fetal morbidity and mortality.

The maternal prognosis of ICP is good. Cholestasis can reoccur in later pregnancies in a 60 -70% of the cases and are variable in severity. The women affected with this illness have a greater risk of developing gallstones.

Gene or region studied

  • ABCC2
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