U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Abnormal liver function tests during pregnancy

MedGen UID:
892927
Concept ID:
C4021883
Finding
Synonym: Abnormal liver function tests during pregnancy, resolves postpartum
 
HPO: HP:0200148

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

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Maness DL, Riley E, Studebaker G
Am Fam Physician 2021 Dec 1;104(6):626-635. PMID: 34913652
Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M; ESC Scientific Document Group
Eur Heart J 2016 Jan 1;37(1):67-119. Epub 2015 Aug 29 doi: 10.1093/eurheartj/ehv317. PMID: 26320113

Recent clinical studies

Etiology

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Braga A, Vasconcelos C, Braga J
Best Pract Res Clin Obstet Gynaecol 2020 Oct;68:23-31. Epub 2020 Mar 16 doi: 10.1016/j.bpobgyn.2020.03.007. PMID: 32376296
Mawson AR, Croft AM
Int J Environ Res Public Health 2019 Sep 22;16(19) doi: 10.3390/ijerph16193543. PMID: 31546693Free 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
Williamson C, Geenes V
Obstet Gynecol 2014 Jul;124(1):120-133. doi: 10.1097/AOG.0000000000000346. PMID: 24901263

Diagnosis

Katarey D, Westbrook RH
Best Pract Res Clin Obstet Gynaecol 2020 Oct;68:12-22. Epub 2020 Apr 7 doi: 10.1016/j.bpobgyn.2020.03.013. PMID: 32381461
Braga A, Vasconcelos C, Braga J
Best Pract Res Clin Obstet Gynaecol 2020 Oct;68:23-31. Epub 2020 Mar 16 doi: 10.1016/j.bpobgyn.2020.03.007. PMID: 32376296
Ma K, Berger D, Reau N
Clin Liver Dis 2019 May;23(2):345-361. Epub 2019 Feb 26 doi: 10.1016/j.cld.2018.12.013. PMID: 30947881
Williamson C, Geenes V
Obstet Gynecol 2014 Jul;124(1):120-133. doi: 10.1097/AOG.0000000000000346. PMID: 24901263
Aggarwal R, Jameel S
Hepatology 2011 Dec;54(6):2218-26. doi: 10.1002/hep.24674. PMID: 21932388

Therapy

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org, Lee RH, Mara Greenberg, Metz TD, Pettker CM
Am J Obstet Gynecol 2021 Feb;224(2):B2-B9. Epub 2020 Nov 13 doi: 10.1016/j.ajog.2020.11.002. PMID: 33197417
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
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP
MMWR Recomm Rep 2018 Jan 12;67(1):1-31. doi: 10.15585/mmwr.rr6701a1. PMID: 29939980Free PMC Article
Rac MW, Revell PA, Eppes CS
Am J Obstet Gynecol 2017 Apr;216(4):352-363. Epub 2016 Dec 9 doi: 10.1016/j.ajog.2016.11.1052. PMID: 27956203

Prognosis

Zhou Q, Kang G, Jiang P, Qiao R, Lam WKJ, Yu SCY, Ma ML, Ji L, Cheng SH, Gai W, Peng W, Shang H, Chan RWY, Chan SL, Wong GLH, Hiraki LT, Volpi S, Wong VWS, Wong J, Chiu RWK, Chan KCA, Lo YMD
Proc Natl Acad Sci U S A 2022 Nov;119(44):e2209852119. Epub 2022 Oct 26 doi: 10.1073/pnas.2209852119. PMID: 36288287Free PMC Article
Choon SE, Navarini AA, Pinter A
Am J Clin Dermatol 2022 Jan;23(Suppl 1):21-29. Epub 2022 Jan 21 doi: 10.1007/s40257-021-00654-z. PMID: 35061227Free PMC Article
Shekhar S, Diddi G
Taiwan J Obstet Gynecol 2015 Oct;54(5):475-82. doi: 10.1016/j.tjog.2015.01.004. PMID: 26522095
Kamimura K, Abe H, Kawai H, Kamimura H, Kobayashi Y, Nomoto M, Aoyagi Y, Terai S
World J Gastroenterol 2015 May 7;21(17):5183-90. doi: 10.3748/wjg.v21.i17.5183. PMID: 25954092Free PMC Article
Almashhrawi AA, Ahmed KT, Rahman RN, Hammoud GM, Ibdah JA
World J Gastroenterol 2013 Nov 21;19(43):7630-8. doi: 10.3748/wjg.v19.i43.7630. PMID: 24282352Free PMC Article

Clinical prediction guides

Zhou Q, Kang G, Jiang P, Qiao R, Lam WKJ, Yu SCY, Ma ML, Ji L, Cheng SH, Gai W, Peng W, Shang H, Chan RWY, Chan SL, Wong GLH, Hiraki LT, Volpi S, Wong VWS, Wong J, Chiu RWK, Chan KCA, Lo YMD
Proc Natl Acad Sci U S A 2022 Nov;119(44):e2209852119. Epub 2022 Oct 26 doi: 10.1073/pnas.2209852119. PMID: 36288287Free PMC Article
Nicloux M, Peterman L, Parodi M, Magny JF
Arch Pediatr 2020 Apr;27(3):160-165. Epub 2020 Feb 29 doi: 10.1016/j.arcped.2020.01.006. PMID: 32127242
Jiang P, Sun K, Peng W, Cheng SH, Ni M, Yeung PC, Heung MMS, Xie T, Shang H, Zhou Z, Chan RWY, Wong J, Wong VWS, Poon LC, Leung TY, Lam WKJ, Chan JYK, Chan HLY, Chan KCA, Chiu RWK, Lo YMD
Cancer Discov 2020 May;10(5):664-673. Epub 2020 Feb 28 doi: 10.1158/2159-8290.CD-19-0622. PMID: 32111602
Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J
BMJ 2017 Nov 22;359:j5024. doi: 10.1136/bmj.j5024. PMID: 29167102Free PMC Article
Custodio H
Pediatr Rev 2016 Feb;37(2):59-69; quiz 70-1. doi: 10.1542/pir.2015-0006. PMID: 26834225

Recent systematic reviews

Marasciulo F, Passerini I, Fichera A, Ferrari F, Odicino FE, Prefumo F
Acta Obstet Gynecol Scand 2024 Apr;103(4):653-659. Epub 2023 Aug 2 doi: 10.1111/aogs.14640. PMID: 37533304Free PMC Article
Ansari A, Vincent JP, Moorhouse L, Shimakawa Y, Nayagam S
Lancet Glob Health 2023 May;11(5):e715-e728. doi: 10.1016/S2214-109X(23)00131-6. PMID: 37061310
Zhan Y, Xu T, Chen T, Wang X
Acta Obstet Gynecol Scand 2022 Jul;101(7):719-727. Epub 2022 May 22 doi: 10.1111/aogs.14380. PMID: 35599353Free 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
Leombroni M, Buca D, Celentano C, Liberati M, Bascietto F, Gustapane S, Marrone L, Manzoli L, Rizzo G, D'Antonio F
Ultrasound Obstet Gynecol 2017 Aug;50(2):167-174. Epub 2017 Jul 9 doi: 10.1002/uog.17244. PMID: 27553859

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...