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August 9, 1965

Recurrent Intrahepatic Cholestasis of Pregnancy: Observations on Pathogenesis

Author Affiliations

From the departments of medicine, pathology, and obstetrics, Fairview Park Hospital, 18101 Lorain Ave, Cleveland.

JAMA. 1965;193(6):542-544. doi:10.1001/jama.1965.03090060132017

RECURRENT idiopathic jaundice is an unusual but benign complication of pregnancy. It is characterized by intense, generalized pruritus, often associated with an obstructive form of icterus, occurring without known cause in the latter half of gestation. Recovery occurs rapidly after delivery. The condition formerly known as pruritus gravidarum with subclinical elevations of levels of both serum bilirubin1 and alkaline phosphatase2,3 and sulfobromophthalein (BSP) retention4 is considered to be a part of the same syndrome. Recurrence of either form of the syndrome can be expected in at least 50 %2,5 of cases. Although there is a tendency to premature labor,2 neither mother nor child is exposed to special risks. The condition often goes undiagnosed because the icteric state is usually mild and is often late in onset or detection. Liver biopsy obtained in the presence of this complication has consistently revealed only a transient intrahepatic cholestasis.6