Hepatic disorders of pregnancy comprise an impressive list of diseases and complications. Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, is considered the most common pregnancy-related liver disease. It takes place in the second or third trimester of gestation and it spontaneously disappears after delivery.
The condition of asymptomatic hypercholanemia of pregnancy (AHP) has recently been reported. AHP is defined as increased serum bile acids in pregnancy in the absence of symptoms and other biochemical markers of ICP or any other hepatobiliary disease.The prevalence of this condition usually increases with gestational age
Bile acids can pose a highly significant risk for the fetus resulting in several adverse perinatal outcomes such as meconium stained amniotic fluid (MSAF), prematurity, fetal distress and stillbirth.
In ICP, MSAF has been reported in 16%-58% of all cases and up to 100% of cases affected by intrauterine death. It has been found that the risk of MSAF is associated not only with the magnitude of hypercholanemia at diagnosis but also with the early gestational onset of raised maternal serum bile acids. The frequency of MSAF is greater in pregnancies with higher reported levels of maternal serum bile acids.