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ROBIN L.TRAVERSMD, LLM
Pruritus in pregnancy is often neglected and may be related to one of the specific pregnancy-related dermatoses such as intrahepatic cholestasis of pregnancy (ICP). Prompt diagnosis and treatment of ICP is essential to minimize perinatal morbidity or in utero fetal death. In this case series of 13 ICP cases, Ambros-Rudolph et al demonstrate that severe pruritus with or without skin changes in the second half of pregnancy should alert the clinician to the possibility of ICP. Diagnosis may be confirmed by serum bile acid level analysis, even in the setting of normal findings on liver function tests. Skin biopsy is typically unnecessary. Prompt treatment with ursodeoxycholic acid can decrease maternal bile acids, prolong the pregnancy, and minimize fetal risks and maternal symptoms.
This Month in Archives of Dermatology. Arch Dermatol. 2007;143(6):696. doi:10.1001/archderm.143.6.696
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