Fetal intracranial hemorrhage in a patient with intrahepatic

Intrahepatic cholestasis of pregnancy (ICP) is associated to unpredictable fetal risks. The mechanisms underlying poor perinatal outcomes are unknown. Intracranial fetal hemorrhage is a possible complication of ICP. A young patient presented with mild ICP and severe transaminases elevation, at 32 weeks of pregnancy. Ultrasound revealed fetal ventriculomegalia probably secondary to intracranial hemorrhage. At 36 weeks a cesarean section was performed. The neonatal imaging confirmed the diagnosis. The etiology of fetal intracranial hemorrhage is multifactorial and not fully understood. It may be related to mild forms of ICP. Active management remains the only way for preventing fetal complications.