Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

William M Hague; Annette Briley; Leonie Callaway; Marloes Dekker Nitert; Jessica Gehlert; Dorothy Graham; Luke Grzeskowiak; Angela Makris; Corey Markus; Philippa Middleton; Michael J. Peek; Antonia Shand; Michael Stark; Jason Waugh

doi:10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

William M Hague, Annette Briley, Leonie Callaway, Marloes Dekker Nitert, Jessica Gehlert, Dorothy Graham, Luke Grzeskowiak, Angela Makris, Corey Markus, Philippa Middleton, Michael J. Peek, Antonia Shand, Michael Stark, Jason Waugh

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

805 Downloads (Pure)

Abstract

•Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%.

•ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder.

•Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe.

•Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain.

•Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

Original language	English
Pages (from-to)	656-665
Number of pages	10
Journal	Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume	63
Issue number	5
Early online date	11 Jul 2023
DOIs	https://doi.org/10.1111/ajo.13719
Publication status	Published - Oct 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

pregnancy
pruritus
stillbirth
total serum bile acids
ursodeoxycholic acid

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10.1111/ajo.13719Licence: CC BY-NC-ND

Final published versionFinal published version, 1.05 MBLicence: CC BY-NC-ND

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Hague, W. M., Briley, A., Callaway, L., Dekker Nitert, M., Gehlert, J., Graham, D., Grzeskowiak, L., Makris, A., Markus, C., Middleton, P., Peek, M. J., Shand, A., Stark, M., & Waugh, J. (2023). Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. Australian and New Zealand Journal of Obstetrics and Gynaecology, 63(5), 656-665. https://doi.org/10.1111/ajo.13719

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title = "Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary",

abstract = "•Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. •ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. •Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. •Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. •Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.",

keywords = "pregnancy, pruritus, stillbirth, total serum bile acids, ursodeoxycholic acid",

author = "Hague, {William M} and Annette Briley and Leonie Callaway and {Dekker Nitert}, Marloes and Jessica Gehlert and Dorothy Graham and Luke Grzeskowiak and Angela Makris and Corey Markus and Philippa Middleton and Peek, {Michael J.} and Antonia Shand and Michael Stark and Jason Waugh",

year = "2023",

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doi = "10.1111/ajo.13719",

language = "English",

volume = "63",

pages = "656--665",

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Hague, WM, Briley, A, Callaway, L, Dekker Nitert, M, Gehlert, J, Graham, D, Grzeskowiak, L, Makris, A, Markus, C, Middleton, P, Peek, MJ, Shand, A, Stark, M & Waugh, J 2023, 'Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary', Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 63, no. 5, pp. 656-665. https://doi.org/10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. / Hague, William M; Briley, Annette; Callaway, Leonie et al.
In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 63, No. 5, 10.2023, p. 656-665.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Intrahepatic cholestasis of pregnancy – Diagnosis and management

T2 - A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

AU - Hague, William M

AU - Briley, Annette

AU - Callaway, Leonie

AU - Dekker Nitert, Marloes

AU - Gehlert, Jessica

AU - Graham, Dorothy

AU - Grzeskowiak, Luke

AU - Makris, Angela

AU - Markus, Corey

AU - Middleton, Philippa

AU - Peek, Michael J.

AU - Shand, Antonia

AU - Stark, Michael

AU - Waugh, Jason

PY - 2023/10

Y1 - 2023/10

N2 - •Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. •ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. •Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. •Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. •Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

AB - •Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. •ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. •Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. •Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. •Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

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KW - stillbirth

KW - total serum bile acids

KW - ursodeoxycholic acid

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AN - SCOPUS:85164499114

SN - 0004-8666

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SP - 656

EP - 665

JO - Australian and New Zealand Journal of Obstetrics and Gynaecology

JF - Australian and New Zealand Journal of Obstetrics and Gynaecology

IS - 5

ER -

Hague WM, Briley A, Callaway L, Dekker Nitert M, Gehlert J, Graham D et al. Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2023 Oct;63(5):656-665. Epub 2023 Jul 11. doi: 10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy – Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

Abstract

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Keywords

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