Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

William M. Hague; Annette Briley; Leonie Callaway; Marloes Dekker Nitert; Jessica Gehlert; Dorothy Graham; Luke Grzeskowiak; Angela Makris; Corey Markus; Philippa Middleton; Michael J. Peek; Antonia Shand; Michael Stark; Jason Waugh

doi:10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

William M. Hague
, Annette Briley
, Leonie Callaway
, Marloes Dekker Nitert
, Jessica Gehlert
, Dorothy Graham
, Luke Grzeskowiak
, Angela Makris
, Corey Markus
, Philippa Middleton
, Michael J. Peek
, Antonia Shand
, Michael Stark
, Jason Waugh

University of Adelaide
Flinders University
Royal Brisbane and Women's Hospital
University of Queensland
Flinders Medical Centre
King Edward Memorial Hospital for Women
Liverpool Hospital
Women's and Children's Hospital Adelaide
Australian National University
University of New South Wales
Auckland District Health Board

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

Original language	English
Pages (from-to)	656-665
Number of pages	10
Journal	Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume	63
Issue number	5
DOIs	https://doi.org/10.1111/ajo.13719
Publication status	Published - Oct 2023
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Open Access - Access Right Statement

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2023 The Authors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

pregnancy
pruritus
stillbirth
total serum bile acids
ursodeoxycholic acid

Access to Document

10.1111/ajo.13719

Cite this

Hague, W. M., Briley, A., Callaway, L., Dekker Nitert, M., Gehlert, J., Graham, D., Grzeskowiak, L., Makris, A., Markus, C., Middleton, P., Peek, M. J., Shand, A., Stark, M., & Waugh, J. (2023). Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. Australian and New Zealand Journal of Obstetrics and Gynaecology, 63(5), 656-665. https://doi.org/10.1111/ajo.13719

@article{55e3738b1afe4b2b89f82dee6f661e3e,

title = "Intrahepatic cholestasis of pregnancy{"} Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary",

abstract = "Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6{\textendash}0.7\%. ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.",

keywords = "pregnancy, pruritus, stillbirth, total serum bile acids, ursodeoxycholic acid",

author = "Hague, \{William M.\} and Annette Briley and Leonie Callaway and \{Dekker Nitert\}, Marloes and Jessica Gehlert and Dorothy Graham and Luke Grzeskowiak and Angela Makris and Corey Markus and Philippa Middleton and Peek, \{Michael J.\} and Antonia Shand and Michael Stark and Jason Waugh",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley \& Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.",

year = "2023",

month = oct,

doi = "10.1111/ajo.13719",

language = "English",

volume = "63",

pages = "656--665",

journal = "Australian and New Zealand Journal of Obstetrics and Gynaecology",

issn = "0004-8666",

publisher = "Wiley-Blackwell Publishing Asia",

number = "5",

}

Hague, WM, Briley, A, Callaway, L, Dekker Nitert, M, Gehlert, J, Graham, D, Grzeskowiak, L, Makris, A, Markus, C, Middleton, P, Peek, MJ, Shand, A, Stark, M & Waugh, J 2023, 'Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary', Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 63, no. 5, pp. 656-665. https://doi.org/10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. / Hague, William M.; Briley, Annette; Callaway, Leonie et al.
In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 63, No. 5, 10.2023, p. 656-665.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Intrahepatic cholestasis of pregnancy" Diagnosis and management

T2 - A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

AU - Hague, William M.

AU - Briley, Annette

AU - Callaway, Leonie

AU - Dekker Nitert, Marloes

AU - Gehlert, Jessica

AU - Graham, Dorothy

AU - Grzeskowiak, Luke

AU - Makris, Angela

AU - Markus, Corey

AU - Middleton, Philippa

AU - Peek, Michael J.

AU - Shand, Antonia

AU - Stark, Michael

AU - Waugh, Jason

N1 - Publisher Copyright: © 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

PY - 2023/10

Y1 - 2023/10

N2 - Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

AB - Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6–0.7%. ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

KW - pregnancy

KW - pruritus

KW - stillbirth

KW - total serum bile acids

KW - ursodeoxycholic acid

UR - https://hdl.handle.net/1959.7/uws:78371

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DO - 10.1111/ajo.13719

M3 - Article

C2 - 37431680

SN - 0004-8666

VL - 63

SP - 656

EP - 665

JO - Australian and New Zealand Journal of Obstetrics and Gynaecology

JF - Australian and New Zealand Journal of Obstetrics and Gynaecology

IS - 5

ER -

Hague WM, Briley A, Callaway L, Dekker Nitert M, Gehlert J, Graham D et al. Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2023 Oct;63(5):656-665. doi: 10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy" Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

Abstract

Bibliographical note

Open Access - Access Right Statement

UN SDGs

Keywords

Access to Document

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Cite this