Patient's question:
During pregnancy, it is always particularly uncomfortable, and morning sickness is also very severe. How is intrahepatic cholestasis of pregnancy treated?Doctor's answer:
Hello, the etiology and pathogenesis of this disease remain unclear. In recent years, most scholars believe it is related to the following factors:1. Increased estrogen levels
During pregnancy, the placenta produces a large amount of estrogen, and the liver becomes more sensitive to estrogen. In 1996, Leslie et al. found evidence of high estrogen concentrations in hepatocytes. Additionally, the incidence of ICP in twin pregnancies is five times higher than in singleton pregnancies, indirectly proving that ICP is related to increased estrogen levels. The mechanisms by which estrogen causes cholestasis include:
- Increased biliary microtubule permeability;
- Changes in the lipid composition of hepatocyte and bile duct membranes, reducing the liquid fluidity of the membranes;
- Decreased activity of hepatocyte membrane Na+-K+-ATPase;
- Abnormal liver protein synthesis;
- Oxidative free radicals produced by estrogen metabolism in hepatocytes, which damage hepatocytes.
2. Genetic factors
ICP often has a family history, with a positive family incidence rate of 36%–50%. The inheritance pattern is autosomal dominant. Males in the family do not develop the disease but may be carriers, passing this susceptibility to female offspring.
3. Medications
Medications during pregnancy, such as chlorpromazine, diazepam, thiourea, nitrofurantoin, sulfonamides, and indomethacin (indocin), may also induce ICP.