Although typically noticed on the palms of the hands and the soles of the feet, the itching can occur anywhere on the body.

[9] Estrogens, and particularly glucuronides such as estradiol-17β-D-glucuronide, have been shown to cause cholestasis in animal studies, by reducing bile acid uptake by hepatocytes.

[9] Genetic mutations in the hepatocellular transport protein ABCB4 (MDR3), which controls secretion of phosphatidylcholine into bile, have been found in cases of ICP.

[14] Genetic mutations affecting hepatic bile salt transport molecules have also been found in patients with progressive familial intrahepatic cholestasis.

[9] In addition to genetic changes to bile salt transport molecules, high levels of estrogen glucuronides have been shown to inhibit the bile salt export pump (BSEP) ABCB11,[15] and high levels of progesterone to inhibit the ABCB4 (MDR3) phospholipid transporter.

[11][22] There is no evidence that giving oral water-soluble Vitamin K may help to avoid the risk of hemorrhage at delivery.

This research, published in The Lancet, also suggests that around 90% of women with ICP could wait until 39 weeks of pregnancy to be induced.

[23][25][26][27][28][29] In the United States, some researchers have suggested that the risk of stillbirth is lower if induction occurs at 36 weeks.