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One group of investigators17 reported safely performing endoscopic retrograde cholangiopancreatography and endoscopic retrograde sphincterotomy without complications in five pregnant women (in the second and third trimesters) with choledocholithiasis using minimal fluoroscopy and lead aprons to nurse shield the abdomen. All of the women delivered healthy babies at term.17 Pregnancy-Specific Liver Disease Intrahepatic Cholestasis of Pregnancy Intrahepatic cholestasis of pregnancy occurs in nurse 0.01 percent of pregnancies in the United States. It typically arises in the third trimester of pregnancy, although it has been reported as early as 13 weeks' gestation.18-20 The pathophysiology of intrahepatic cholestasis of pregnancy nurse remains poorly understood.19 Pruritus alone occurs in 80 percent of patients; pruritus and jaundice develop in 20 percent of patients.20 Laboratory abnormalities include a bilirubin level less than 5 mg per dL (85.5 µmol per L), minimal or no elevation in transaminase, cholesterol and triglyceride levels, and infrequent, mild to moderate steatorrhea.
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