What risks and outcomes are associated with intrahepatic cholestasis of pregnancy?

The main risks are to the fetus; the fetus is unable to excrete cholic acid, resulting in toxicity. Sudden intrauterine fetal death occurs in 1% to 2% of pregnancies affected by ICP. Other complications include respiratory distress syndrome, meconium staining of amniotic fluid membranes, and premature delivery. The risk of fetal complications increases with bile acids levels >40 µM/L. There are not usually any long-term maternal sequelae. The pruritus associated with ICP usually resolves within 48 hours to 2 weeks, after delivery.

Hepburn I: Pregnancy-associated liver disorders, Dig Dis Sci (53):2334–2358, 2008.