Cholestasis of pregnancy is observed in approximately 1% of the pregnancies. It occurs during the second or third trimester and is characterized by pruritus and abnormal liver function tests, in particular, elevated aminotransferases and alkaline phosphatase activities [1]. Symptoms and biochemical abnormalities should resolve completely within at most 4 weeks after delivery. However, in some cases, liver tests remain persistently abnormal after this 4-week period. This finding should prompt the attending physician to search for an underlying hepatobiliary disease that requires further diagnostic testing. The prevalence and nature of such underlying diseases are not precisely known, although previous studies have shown associations of intrahepatic cholestasis of pregnancy (ICP) with gallstone disease [1] and hepatitis C [2]. To determine this prevalence and identify the diseases, Marschall et al. have analysed data from a large cohort of women registered in the Swedish Medical Birth Register between 1973 and 2009 [3].
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