2 Statistics Cholestasis of pregnancy is a relatively rare condition affecting pregnant women. However, the severity of ICP may vary from one pregnancy to the next 13 and may skip pregnancies entirely. The condition is also up to four times as common in twin or triplet pregnancies than in singleton pregnancies. The term cholestasis refers to a condition in which there is abnormal flow of bile from the liver into the intestine. Bile is a fluid created in the liver that contains, among other substances, bile salts and bilirubin.
Bile salts aid in emulsifying and absorbing fats in the intestine.
When the flow of bile is impaired, the blood levels of bile acids and bilirubin increase. While the exact cause is not known, it is widely accepted that in affected women, the membranes of the liver cells are somehow altered by the high estrogen level in the blood during pregnancy. It is thought that the altered membranes are impaired in their function of transporting bile out of the liver so that bile salts and other liver products begin to build up in the blood. The idea of increased estrogen sensitivity is supported by cases of ICP that have arisen in non-pregnant women taking oral contraceptives that contain estrogen. The classic symptom of intrahepatic cholestasis of pregnancy is intense generalized pruritus.