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

ObjectiveTo assess whether routine viral and autoimmunehepatitis tests and hepatobiliary ultrasonography aidin diagnosing and managing intrahepatic cholestasisof pregnancy.Material and MethodThis retrospective study reviewed 120 pregnantwomen diagnosed with ICP at a tertiary care centerfrom 2020 to 2025. Demographic, clinical, andlaboratory 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 andtreatment planning.ResultsThe mean age and BMI of patients were 29.6 ± 5.3years and 29.3 ± 5.5 kg/m², respectively. The meangestational week at diagnosis was 32.5 ± 4.2, andthe mean delivery week was 36.3 ± 2.1. HBsAgpositivity was observed in 0.83% of patients, whileno 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 1hepatic steatosis. However, these did not result inchanges in clinical management.ConclusionRoutine testing for viral and autoimmune hepatitismarkers and hepatobiliary ultrasound in ICP patientsoffers limited diagnostic benefit and seldom affectstreatment decisions. These findings support a moretargeted and cost-effective strategy, reservingadditional tests for atypical cases or patients withtreatment resistance.