Intrahepatic cholestasis of pregnancy: Diagnosis and management; A survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows

Arthur, Chris and Mahomed, Kassam (2014) Intrahepatic cholestasis of pregnancy: Diagnosis and management; A survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows. Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 3: 263-267. doi:10.1111/ajo.12178


Author Arthur, Chris
Mahomed, Kassam
Title Intrahepatic cholestasis of pregnancy: Diagnosis and management; A survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows
Journal name Australian and New Zealand Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 1479-828X
0004-8666
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/ajo.12178
Open Access Status Not Open Access
Volume 54
Issue 3
Start page 263
End page 267
Total pages 5
Place of publication Richmond, VIC Australia
Publisher Blackwell Publishing
Language eng
Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines. Aims To conduct a survey of Fellows and Members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) regarding their diagnosis and management ICP. Methods An online survey of currently practising RANZCOG Fellows and Members, utilising Survey Monkey. Results Thirty percent of those sent the survey responded, comprising approximately 40% of practising obstetricians. Fasting bile acid and serum transaminase elevation in association with the characteristic itch define the disease process for the majority of respondents and also inform management decisions. There was no critical level of bile acid elevation that mandated treatment for the majority of respondents. Nearly 90% of respondents induce women with ICP at 37-38 completed weeks of pregnancy, due to concerns regarding possible fetal demise. About one-third of respondents refer to the Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline to advise their decision-making process, and a similar proportion use local or hospital-based guidelines. Conclusions Elevated fasting bile acids and abnormal liver function tests define the diagnosis and inform management of ICP by Australian obstetricians. Routine induction of labour for patients with ICP at 37-38 completed weeks of pregnancy is widely practised in Australia. An evidence-based guideline would assist clinicians who manage such cases in Australia.
Keyword Cholestasis
Diagnosis
Disease management
Health Surveys
Intrahepatic
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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