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The sudden onset, late in pregnancy, of excruciating pruritus, especially affecting the palms and soles and leading to generalized itching and secondary skin lesions of excoriations and prurigo nodules, characterizes intrahepatic cholestasis of pregnancy (ICP); the condition is also known as recurrent cholestasis of pregnancy or prurigo gravidum. Because ICP is associated with premature labor, fetal distress, and low birth weight, identification and treatment of these patients is important.
At an Austrian university center studying pruritus in pregnancy, it took 6 years to identify 13 patients with ICP from among 228 pregnant women with skin disease. ICP began at a mean of 30 weeks’ gestation (range, 24–35 weeks). Seven patients had experien…