Eureka! Institutional Repository

Intrahepatic Cholestasis of Pregnancy (ICP) is an itchy liver disorder that first appears in the 2nd-3rd trimester of pregnancy and is characterized by secondary skin lesions due to pruritus and disturbed liver laboratory tests. It affects 0.1-15.6% of pregnancies and this percentage is subject to ethnic and geographic differences. It represents a multifactorial liver syndrome with a characteristically benign and reversible course. However, in cases where the disease remains undiagnosed or untreated, it can cause multiple complications (premature labor, meconium-stained amniotic fluid, etc.), with sudden intrauterine fetal death being the worst outcome. The initial diagnosis is based on pruritus starting from the palms and soles without an accompanying rash, and is confirmed by elevated maternal serum bile acid concentrations. The basic treatment plan is to discuss with the woman and provide personalized care by the competent health professionals. The aim of the therapeutic intervention is the remission of the maternal symptoms combined with the normalization of the biochemical parameters, with the ultimate aim of avoiding any adverse outcome. Ursodeoxycholic acid (UDCA) is the drug of choice for this condition and appears to improve pruritus in pregnant women at the same time as reducing serum transaminase and bile acid levels. The midwife, as a member of the interdisciplinary team that has undertaken the care of the pregnant woman with ICP, has a decisive role as she encourages the pregnant woman, provides the necessary counseling and monitors the progress of the pregnancy, showing sensitivity and empathy and providing her scientific knowledge. With the contribution of the entire interdisciplinary team and the dedication of the pregnant woman herself to the therapeutic approach, a healthy pregnancy and finally a safe delivery will be achieved. The assignment that follows is a review of the international literature on topics such as the pathophysiology, the predisposing factors, the effects, the diagnosis and the treatment plan of this liver disease.