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DOI: 10.1055/a-1386-3912
Management der intrahepatischen Schwangerschaftscholestase (Intrahepatic Cholestasis of Pregnancy – ICP): Empfehlungen der Arbeitsgemeinschaft Geburtshilfe und Pränatalmedizin (AGG – Sektion Maternale Erkrankungen)
Article in several languages: English | deutsch![](https://www.thieme-connect.de/media/gebfra/202108/lookinside/thumbnails/10-1055-a-1386-3912_gf_de-1.jpg)
Zusammenfassung
Die Schwangerschaftscholestase (Intrahepatic Cholestasis of Pregnancy, ICP) ist die häufigste schwangerschaftsspezifische Lebererkrankung. Das Leitsymptom Juckreiz und eine begleitende Konzentrationserhöhung von Gallensäuren im Serum und/oder der Alanin-Aminotransferase (ALT) sind richtungsweisend für die Diagnosestellung. Insgesamt ist die mütterliche Prognose gut. Das fetale Outcome ist abhängig von der Gallensäurenkonzentration. Die ICP ist sowohl mit einer Frühgeburt als auch mit dem intrauterinem Fruchttod (IUFT) assoziiert. Ursächlich ist eine akute fetale Asphyxie und nicht eine chronische uteroplazentare Dysfunktion. Daher ist ein prädiktives Monitoring, z. B. durch CTG oder Ultraschall nicht möglich. Eine medikamentöse Therapie mit Ursodeoxycholsäure (UDCA) bessert den Juckreiz – beeinflusst jedoch das fetale Outcome nicht nachweislich. Eine Entbindungsindikation ergibt sich in Abhängigkeit der Gallensäurenkonzentration und des Gestationsalters. In Folgeschwangerschaften besteht ein hohes Wiederholungsrisiko.
Schlüsselwörter
Totgeburt - Weheneinleitung - Gallensäuren - Lebererkrankung - Ursodeoxycholsäure - PruritusPublication History
Received: 13 January 2021
Accepted after revision: 05 February 2021
Article published online:
09 August 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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