What characterizes intrahepatic cholestasis of pregnancy?

Intrahepatic cholestasis of pregnancy is primarily characterized by generalized pruritus without rash. This condition arises from the disturbances in bile flow due to hormonal changes during pregnancy, particularly the increased levels of estrogen and progesterone. The pruritus is often more pronounced on the palms of the hands and soles of the feet and can be quite distressing for the affected individual. The absence of a rash is also a distinguishing feature, differentiating it from other causes of itching during pregnancy.

Severe abdominal pain is not typically associated with intrahepatic cholestasis. While there may be some mild discomfort due to liver enlargement in severe cases, significant pain is more indicative of other hepatic issues. Swelling of the extremities can occur in normal pregnancy and is not specific to intrahepatic cholestasis; it often relates to fluid retention rather than biliary issues. Stretch marks, or striae gravidarum, are common during pregnancy due to skin stretching and weight gain, and are not a symptom of intrahepatic cholestasis.

Thus, the presence of generalized pruritus without any accompanying rash is a hallmark symptom of this condition, making it the correct characterization.