Review Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management

Cholestasis, or impaired bile flow, is one of themost common and devastating manifestations of hereditary and acquired liver diseases. Intrahepatic cholestasis of pregnancy (ICP) is a reversible form of cholestasis in late pregnancy, persisting until delivery. The first case of unexplained pruritus associated with visible jaundice appearing in the last trimester of preg-nancy and clearing shortly after delivery was reported in 1883 (1). The disease remained unnoticed and un-named until the mid-1950s when the detailed clinical features were described by several Scandinavian clini-cians [for a review, see (2)]. Familial clustering and en-demic occurrence of cholestasis of pregnancy strongly indicated a genetic basis. Recent progress in molecular dissection of bile secretion has led to the identification of several gene defects that cause cholestatic liver dis