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

Year 2026, Volume: 33 Issue: 1, 87 - 92, 21.03.2026

Ebu Bekir Siddik Yilmaz , Serenat Yalçın

https://doi.org/10.17343/sdutfd.1740780

https://izlik.org/JA46RU69HC

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

Ethical Statement

The study was conducted in strict accordance with the principles of the Declaration of Helsinki and was approved by the Institutional Review Board of Bursa City Hospital (30.04.2025-2025-9/8). As this was a retrospective study using anonymized patient data, the requirement for informed patient consent was waived by the institutional review board.

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.

Project Number

2025-9/8

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