Podcast: Intrahepatic Cholestasis of Pregnancy: A Primer for Non-Hepatology APPs

In this podcast, hepatology nurse practitioner Allysa Saggese and physician assistant Elizabeth Goacher discuss intrahepatic cholestasis of pregnancy (ICP), focusing on what advanced practice providers and non-hepatology clinicians should recognize about itching and liver abnormalities during pregnancy. The conversation explores hallmark symptoms, including itchy palms and soles, the typical presentation in the third trimester, and the role of serum bile acid testing and liver enzymes in evaluation. They discuss potential fetal complications, ursodiol treatment, delivery planning, and the importance of coordinated care between obstetrics, maternal-fetal medicine, and hepatology. Additional topics include postpartum monitoring, the risk of recurrence in future pregnancies, and further evaluation for underlying liver or biliary disease when symptoms or laboratory abnormalities persist. Allysa and Elizabeth also highlight warning signs that require prompt assessment, including jaundice, markedly abnormal liver tests, and altered mental status, while discussing the importance of distinguishing ICP from other serious conditions, such as acute fatty liver of pregnancy and HELLP syndrome. Designed for nurse practitioners, physician assistants, primary care providers, and clinicians caring for pregnant patients, this episode emphasizes asking about itching, recognizing concerning symptoms, and connecting patients with appropriate specialty care during pregnancy and postpartum. For related educational content, check out the Cholestatic Liver Disease Community Network.