Intrahepatic cholestasis of pregnancy (ICP) is a liver condition that usually causes itching without a rash, often on the palms and soles. Diagnosis depends on symptoms and blood tests, and care focuses on maternal symptoms, repeat testing and planning birth according to the overall risk profile.
Symptoms and diagnosis
ICP typically causes itching without a primary rash. A clinician will also consider skin conditions, allergies and other liver or gallbladder problems. Blood tests include bile acids and liver function; repeat testing is important when itching persists despite an initially normal result.
What the results mean
Risk is not determined by one symptom alone. Bile-acid concentration, trend over time, gestational age, multiple pregnancy and conditions such as pre-eclampsia or diabetes all influence decisions. Results should be interpreted with the laboratory range and local protocol.
Management and birth planning
Treatment may be offered to reduce itching and improve biochemical results, while pregnancy care includes review of movements, blood tests and discussion of fetal surveillance. Timing of birth is individualised rather than based on a single universal date.
After birth and future pregnancies
Symptoms usually improve after birth, but follow-up blood tests are used to confirm recovery. Persistent abnormal results require further assessment. Recurrence in a future pregnancy is common, so early reporting of itching is important.
Questions worth discussing at your consultation
- How often should bile acids and liver tests be repeated?
- Does my current bile-acid level change the recommended timing of birth?
- What should I do if fetal movements change?
- When will liver tests be checked after birth?