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The only definitive treatment for the condition is prompt delivery. The risk of liver pregnancy acute fatty liver pregnancy liver of pregnancy is not increased in subsequent pregnancies. 17.4.2 INTRHEPATIC CHOLESTASIS OF PREGNANCY Intrahepatic cholestasis liver pregnancy of pregnancy accounts for 20-25% of cases of jaundice during pregnancy. The etiology is unknown. There is a clear genetic predisposition, likely autosomal dominant, with an increased frequency in women of Scandinavian or Chilean descent. The cholestasis (failure of bile formation) represents an exaggerated response of the liver to the normal increase in endogenous estrogens during pregnancy. Presentation typically is in the third trimester with the insidious onset of pruritus. In half of these patients, jaundice follows. Other cholestatic features include dark urine and, occasionally, pale stool. Otherwise women generally feel well, without nausea, vomiting or abdominal pain. Serum alkaline phosphatase and cholesterol rise, but aminotransferases are only modestly elevated.
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