Unexplained First Trimester Intrahepatic Cholestasis of Pregnancy: A Case Report and Literature Review

Table 1

Characteristics of all cases of first trimester ICP documented in the literature.

Article title	Number of cases	Predisposing factor	Ethnicity	Gestational age at diagnosis/onset of symptoms	Bile acid level at the time of diagnosis (micro-mole/L)	Pregnancy Outcome
Kirkinen et al. 1995	1	(i) Triploid fetus	Not available	Not available	Not available	Not specified
		(ii) Elevated alpha Fetoprotein
Brites et al. 1998	1	Not specified	Not available	11 weeks of gestation	198 at 20 weeks of gestation	IOL at 36 weeks of gestation.
						Baby had intestinal stenosis
Zamah et al. 2008	2	(i) IVF treatment	Asian	8 weeks of gestation	137.2	IOL at term due to oligohydramnios
		(ii) Moderate OHSS	East Indian	6 weeks of gestation	308	Spontaneous miscarriage at 9 weeks of gestation
Steele et al. 2012	1	(i) First pregnancy No obvious risk factors	British	11 weeks of gestation	205 at 16 weeks of gestation	Emergency cesarean for nonreassuring fetal heart at 32^+2 weeks of gestation
Johnston et al. 2014	1	(i) Recurrent ICP	Not available	8 weeks of gestation	217	PPROM at 30^+5 weeks of gestation
		(ii) Heterozygous mutation of ABCB4 gene				c/s for malpresentation
Hubschmann et al. 2016	1	(i) Recurrent ICP	Guatemalan	7^+5 weeks of gestation	243.6 at 13^+5 weeks of gestation	Elective cesarean section at 31^+6 weeks of gestation
Mutlu et al. 2017	2	(i) IVF treatment	Turkish	6 weeks of gestation	166.8	Blighted ovum
		(ii) Moderate OHSS	Turkish	5 weeks of gestation	122	PPROM at 36 WG with delivery of twins via cesarean section
Our case	1	(i) No known risk factors	Lebanese	10 weeks of gestation	9.1 at 18 weeks of gestation	IOL at 37 weeks of gestation.