Simplifying Management of Cholestasis: A Proposal for a Classification System.

Given the stillbirth risk associated with intrahepatic cholestasis of pregnancy, management to reduce this adverse outcome has primarily involved planned delivery as early as 36 weeks gestation. While earlier planned delivery has decreased the incidence of stillbirth in this population, recently, th...

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Publicado en:American Journal of Perinatology Vol. 42; no. 9; pp. 1229 - 1235
Autores principales: Sarker, Minhazur, Ramos, Gladys A., Ferrara, Lauren, Gyamfi-Bannerman, Cynthia
Formato: algorithm review tables/charts Journal Article
Publicado: Thieme Medical Publishing Inc. Jul2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2025
      vid: 42
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      pub: Thieme Medical Publishing Inc.
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        10.1055/a-2495-3553
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        atl: Simplifying Management of Cholestasis: A Proposal for a Classification System.
      aug:
        au:
          Sarker, Minhazur
          Ramos, Gladys A.
          Ferrara, Lauren
          Gyamfi-Bannerman, Cynthia
        affil: Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California
      sug:
        subj:
          Cholestasis, Intrahepatic Complications
          Cholestasis, Intrahepatic Therapy
          Pregnancy Complications Risk Factors
          Risk Assessment
          Pregnancy
          Female
          Practice Guidelines
          Algorithms
          Female
      ab: Given the stillbirth risk associated with intrahepatic cholestasis of pregnancy, management to reduce this adverse outcome has primarily involved planned delivery as early as 36 weeks gestation. While earlier planned delivery has decreased the incidence of stillbirth in this population, recently, there have been multiple published retrospective studies to better correlate the association of adverse outcomes with cholestasis severity. Despite these new data, the uptake of individualized management for cholestasis has been varied from provider to provider. In this opinion, we briefly review the current literature and evidence regarding cholestasis and adverse outcomes and propose a cholestasis classification system with subsequent algorithms for management. Key Points: Recently, multiple studies have further characterized adverse outcomes with cholestasis. Incorporation of severity-associated management into clinical practice is variable. A cholestasis classification system will simplify and streamline management.
      pubtype: Academic Journal
      doctype:
        algorithm
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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