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Increased serum bile acid concentration during pregnancy

MedGen UID:
892830
Concept ID:
C4021882
Finding
Synonym: Increased serum bile acid concentration during pregnancy, resolves
 
HPO: HP:0200150

Term Hierarchy

Conditions with this feature

Cholestasis, intrahepatic, of pregnancy, 1
MedGen UID:
762759
Concept ID:
C3549845
Disease or Syndrome
Intrahepatic cholestasis of pregnancy is a reversible form of cholestasis that occurs most often in the third trimester of pregnancy and recurs in 45 to 70% of subsequent pregnancies. Symptoms include pruritus, jaundice, increased serum bile salts, and abnormal liver enzymes, all of which resolve rapidly after delivery. However, the condition is associated with fetal complications, including placental insufficiency, premature labor, fetal distress, and intrauterine death. Some women with ICP may also be susceptible to oral contraceptive-induced cholestasis (OCIC) (summary by Pasmant et al., 2012). Genetic Heterogeneity of Intrahepatic Cholestasis of Pregnancy See also ICP3 (614972), caused by mutation in the ABCB4 gene (171060).
Cholestasis, intrahepatic, of pregnancy, 3
MedGen UID:
767155
Concept ID:
C3554241
Disease or Syndrome
Intrahepatic cholestasis of pregnancy is a reversible form of cholestasis that occurs most often in the third trimester of pregnancy and recurs in 45 to 70% of subsequent pregnancies. Symptoms include pruritus, jaundice, increased serum bile salts, and abnormal liver enzymes, all of which resolve rapidly after delivery. However, the condition is associated with fetal complications, including placental insufficiency, premature labor, fetal distress, and intrauterine death. Women with ICP are also susceptible to oral contraceptive-induced cholestasis (OCIC). Ursodeoxycholic acid (UDCA) is an effective treatment for conditions caused by ABCB4 mutations (summary by Pasmant et al., 2012). Mutation in the ABCB4 gene accounts for about 15% of ICP cases (summary by Ziol et al., 2008). For a discussion of genetic heterogeneity of ICP, see ICP1 (147480).

Professional guidelines

PubMed

Manna LB, Ovadia C, Lövgren-Sandblom A, Chambers J, Begum S, Seed P, Walker I, Chappell LC, Marschall HU, Williamson C
BJOG 2019 Dec;126(13):1633-1640. Epub 2019 Sep 26 doi: 10.1111/1471-0528.15926. PMID: 31483939Free PMC Article
Kremer AE, Namer B, Bolier R, Fischer MJ, Oude Elferink RP, Beuers U
Dig Dis 2015;33 Suppl 2:164-75. Epub 2015 Dec 7 doi: 10.1159/000440829. PMID: 26641452
Heikkinen J, Mäentausta O, Ylöstalo P, Jänne O
Eur J Obstet Gynecol Reprod Biol 1982 Dec;14(3):153-62. doi: 10.1016/0028-2243(82)90090-9. PMID: 7160524

Recent clinical studies

Etiology

Zhang F, Liu F, Xu X, Su W, Rong Y, Tian FY, Xiao W, Wu Y, Law KP, Wen P
Clin Chim Acta 2024 Apr 15;557:117854. Epub 2024 Mar 20 doi: 10.1016/j.cca.2024.117854. PMID: 38513931
Schoonejans JM, Fan HM, Mitchell AL, Lövgren-Sandblom A, Sukumar N, Periyathambi N, Weldeselassie Y, Seed PT, Molinaro A, Marschall HU, Saravanan P, Williamson C
BJOG 2024 Aug;131(9):1218-1228. Epub 2024 Feb 29 doi: 10.1111/1471-0528.17798. PMID: 38424005
Liu Y, Sun R, Li Y, Chen H, Wu L, Shen S, Wei Y, Wang N, Zhang Z, Liu Z, Deng G
Clin Chim Acta 2021 Sep;520:160-167. Epub 2021 Jun 6 doi: 10.1016/j.cca.2021.05.036. PMID: 34102134
Chappell LC, Bell JL, Smith A, Linsell L, Juszczak E, Dixon PH, Chambers J, Hunter R, Dorling J, Williamson C, Thornton JG; PITCHES study group
Lancet 2019 Sep 7;394(10201):849-860. Epub 2019 Aug 1 doi: 10.1016/S0140-6736(19)31270-X. PMID: 31378395Free PMC Article
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, Kohari K, Bacq Y, Bozkurt N, Brun-Furrer R, Bull L, Estiú MC, Grymowicz M, Gunaydin B, Hague WM, Haslinger C, Hu Y, Kawakita T, Kebapcilar AG, Kebapcilar L, Kondrackienė J, Koster MPH, Kowalska-Kańka A, Kupčinskas L, Lee RH, Locatelli A, Macias RIR, Marschall HU, Oudijk MA, Raz Y, Rimon E, Shan D, Shao Y, Tribe R, Tripodi V, Yayla Abide C, Yenidede I, Thornton JG, Chappell LC, Williamson C
Lancet 2019 Mar 2;393(10174):899-909. Epub 2019 Feb 14 doi: 10.1016/S0140-6736(18)31877-4. PMID: 30773280Free PMC Article

Diagnosis

Zhang F, Liu F, Xu X, Su W, Rong Y, Tian FY, Xiao W, Wu Y, Law KP, Wen P
Clin Chim Acta 2024 Apr 15;557:117854. Epub 2024 Mar 20 doi: 10.1016/j.cca.2024.117854. PMID: 38513931
Piechota J, Jelski W, Orywal K, Mroczko B
Acta Biochim Pol 2021 Nov 24;69(1):173-176. doi: 10.18388/abp.2020_5841. PMID: 34817951
Vasavan T, Deepak S, Jayawardane IA, Lucchini M, Martin C, Geenes V, Yang J, Lövgren-Sandblom A, Seed PT, Chambers J, Stone S, Kurlak L, Dixon PH, Marschall HU, Gorelik J, Chappell L, Loughna P, Thornton J, Pipkin FB, Hayes-Gill B, Fifer WP, Williamson C
J Hepatol 2021 May;74(5):1087-1096. Epub 2020 Dec 1 doi: 10.1016/j.jhep.2020.11.038. PMID: 33276032Free PMC Article
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, Kohari K, Bacq Y, Bozkurt N, Brun-Furrer R, Bull L, Estiú MC, Grymowicz M, Gunaydin B, Hague WM, Haslinger C, Hu Y, Kawakita T, Kebapcilar AG, Kebapcilar L, Kondrackienė J, Koster MPH, Kowalska-Kańka A, Kupčinskas L, Lee RH, Locatelli A, Macias RIR, Marschall HU, Oudijk MA, Raz Y, Rimon E, Shan D, Shao Y, Tribe R, Tripodi V, Yayla Abide C, Yenidede I, Thornton JG, Chappell LC, Williamson C
Lancet 2019 Mar 2;393(10174):899-909. Epub 2019 Feb 14 doi: 10.1016/S0140-6736(18)31877-4. PMID: 30773280Free PMC Article
Brites D
Ann Hepatol 2002 Jan-Mar;1(1):20-8. PMID: 15114292

Therapy

Vasavan T, Deepak S, Jayawardane IA, Lucchini M, Martin C, Geenes V, Yang J, Lövgren-Sandblom A, Seed PT, Chambers J, Stone S, Kurlak L, Dixon PH, Marschall HU, Gorelik J, Chappell L, Loughna P, Thornton J, Pipkin FB, Hayes-Gill B, Fifer WP, Williamson C
J Hepatol 2021 May;74(5):1087-1096. Epub 2020 Dec 1 doi: 10.1016/j.jhep.2020.11.038. PMID: 33276032Free PMC Article
Chappell LC, Bell JL, Smith A, Linsell L, Juszczak E, Dixon PH, Chambers J, Hunter R, Dorling J, Williamson C, Thornton JG; PITCHES study group
Lancet 2019 Sep 7;394(10201):849-860. Epub 2019 Aug 1 doi: 10.1016/S0140-6736(19)31270-X. PMID: 31378395Free PMC Article
Manzotti C, Casazza G, Stimac T, Nikolova D, Gluud C
Cochrane Database Syst Rev 2019 Jul 5;7(7):CD012546. doi: 10.1002/14651858.CD012546.pub2. PMID: 31283001Free PMC Article
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, Kohari K, Bacq Y, Bozkurt N, Brun-Furrer R, Bull L, Estiú MC, Grymowicz M, Gunaydin B, Hague WM, Haslinger C, Hu Y, Kawakita T, Kebapcilar AG, Kebapcilar L, Kondrackienė J, Koster MPH, Kowalska-Kańka A, Kupčinskas L, Lee RH, Locatelli A, Macias RIR, Marschall HU, Oudijk MA, Raz Y, Rimon E, Shan D, Shao Y, Tribe R, Tripodi V, Yayla Abide C, Yenidede I, Thornton JG, Chappell LC, Williamson C
Lancet 2019 Mar 2;393(10174):899-909. Epub 2019 Feb 14 doi: 10.1016/S0140-6736(18)31877-4. PMID: 30773280Free PMC Article
Brites D
Ann Hepatol 2002 Jan-Mar;1(1):20-8. PMID: 15114292

Prognosis

Zhu B, Ma Z, Zhu Y, Fang L, Zhang H, Kong H, Xia D
J Zhejiang Univ Sci B 2021 Mar 15;22(3):223-232. doi: 10.1631/jzus.B2000483. PMID: 33719227Free PMC Article
Ovadia C, Perdones-Montero A, Spagou K, Smith A, Sarafian MH, Gomez-Romero M, Bellafante E, Clarke LCD, Sadiq F, Nikolova V, Mitchell A, Dixon PH, Santa-Pinter N, Wahlström A, Abu-Hayyeh S, Walters JRF, Marschall HU, Holmes E, Marchesi JR, Williamson C
Hepatology 2019 Jul;70(1):276-293. Epub 2019 May 21 doi: 10.1002/hep.30661. PMID: 30983011Free PMC Article
Kremer AE, Namer B, Bolier R, Fischer MJ, Oude Elferink RP, Beuers U
Dig Dis 2015;33 Suppl 2:164-75. Epub 2015 Dec 7 doi: 10.1159/000440829. PMID: 26641452
Brites D
Ann Hepatol 2002 Jan-Mar;1(1):20-8. PMID: 15114292
Lunzer M, Barnes P, Byth K, O'Halloran M
Gastroenterology 1986 Oct;91(4):825-9. doi: 10.1016/0016-5085(86)90682-7. PMID: 3743960

Clinical prediction guides

Song F, Chen Y, Chen L, Li H, Cheng X, Wu W
JAMA Netw Open 2021 Jul 1;4(7):e2117409. doi: 10.1001/jamanetworkopen.2021.17409. PMID: 34279647Free PMC Article
Liu Y, Sun R, Li Y, Chen H, Wu L, Shen S, Wei Y, Wang N, Zhang Z, Liu Z, Deng G
Clin Chim Acta 2021 Sep;520:160-167. Epub 2021 Jun 6 doi: 10.1016/j.cca.2021.05.036. PMID: 34102134
Zhu B, Ma Z, Zhu Y, Fang L, Zhang H, Kong H, Xia D
J Zhejiang Univ Sci B 2021 Mar 15;22(3):223-232. doi: 10.1631/jzus.B2000483. PMID: 33719227Free PMC Article
Kremer AE, Namer B, Bolier R, Fischer MJ, Oude Elferink RP, Beuers U
Dig Dis 2015;33 Suppl 2:164-75. Epub 2015 Dec 7 doi: 10.1159/000440829. PMID: 26641452
Brites D
Ann Hepatol 2002 Jan-Mar;1(1):20-8. PMID: 15114292

Recent systematic reviews

Manzotti C, Casazza G, Stimac T, Nikolova D, Gluud C
Cochrane Database Syst Rev 2019 Jul 5;7(7):CD012546. doi: 10.1002/14651858.CD012546.pub2. PMID: 31283001Free PMC Article
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, Kohari K, Bacq Y, Bozkurt N, Brun-Furrer R, Bull L, Estiú MC, Grymowicz M, Gunaydin B, Hague WM, Haslinger C, Hu Y, Kawakita T, Kebapcilar AG, Kebapcilar L, Kondrackienė J, Koster MPH, Kowalska-Kańka A, Kupčinskas L, Lee RH, Locatelli A, Macias RIR, Marschall HU, Oudijk MA, Raz Y, Rimon E, Shan D, Shao Y, Tribe R, Tripodi V, Yayla Abide C, Yenidede I, Thornton JG, Chappell LC, Williamson C
Lancet 2019 Mar 2;393(10174):899-909. Epub 2019 Feb 14 doi: 10.1016/S0140-6736(18)31877-4. PMID: 30773280Free PMC Article

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