Routine Viral and Autoimmune Tests in Intrahepatic Cholestasis of Pregnancy: Are They Really Necessary?

Abstract

Objective To assess whether routine viral and autoimmune hepatitis tests and hepatobiliary ultrasonography aid in diagnosing and managing intrahepatic cholestasis of pregnancy. Material and Method This retrospective study reviewed 120 pregnant women diagnosed with ICP at a tertiary care center from 2020 to 2025. Demographic, clinical, and laboratory data-including viral (HBsAg, Anti-HCV, Anti-HIV, CMV, EBV), autoimmune (ANA, SMA, AMA, Anti-LKM), and ultrasonographic findings— were analyzed to evaluate their role in diagnosis and treatment planning. Results The mean age and BMI of patients were 29.6 ± 5.3 years and 29.3 ± 5.5 kg/m², respectively. The mean gestational week at diagnosis was 32.5 ± 4.2, and the mean delivery week was 36.3 ± 2.1. HBsAg positivity was observed in 0.83% of patients, while no cases were positive for Anti-HCV or Anti-HIV. Autoimmune markers were completely negative. Abnormal ultrasound findings were detected in 31.8% of patients, most commonly gallstones and grade 1 hepatic steatosis. However, these did not result in changes in clinical management. Conclusion Routine testing for viral and autoimmune hepatitis markers and hepatobiliary ultrasound in ICP patients offers limited diagnostic benefit and seldom affects treatment decisions. These findings support a more targeted and cost-effective strategy, reserving additional tests for atypical cases or patients with treatment resistance.

Keywords

• Autoimmune hepatitis markers
• Bile acids
• Hepatobiliary ultrasonography
• Intrahepatic cholestasis of pregnancy
• Viral hepatitis markers

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