Cholestasis During Pregnancy: Aetiopathogenesis, Foetal-Maternal Repercussions and Pharmacological Treatments

The lack of elimination of potentially toxic compounds due to impaired bile formation by the maternal liver results in deleterious effects for the trio formed by the foetal liver, the placenta and the maternal liver, which constitutes a key excretory pathway during gestation. One of the most frequent causes of this condition is intrahepatic cholestasis of pregnancy (ICP). This is a pregnancy-specific disorder that mainly occurs during the third trimester of pregnancy and is characterised primarily by pruritus, altered serum levels of liver enzymes and, less frequently, jaundice. ICP has been associated with spontaneous preterm labour and increased foetal morbidity and mortality. Although the pathogenesis of the disease remains obscure, significant advances have been made. These include the investigation of the repercussions of the accumulation of biliary compounds on the structure and function of the foetal liver, the placenta and the maternal liver. The present review provides an overview of current information on this topic as well as on the pharmacological remedies used to treat these patients.