298: Association of bile acid concentrations with adverse pregnancy outcome in an era of aggressive management for intrahepatic cholestasis of pregnancy

2007 ◽  
Vol 197 (6) ◽  
pp. S93
Author(s):  
Richard Lee ◽  
Kaymay Kwok ◽  
Sue Ingles ◽  
Melissa L. Wilson ◽  
Marc Incerpi ◽  
...  
2021 ◽  
Vol 29 (11) ◽  
pp. 654-657
Author(s):  
Irshad Ahmed ◽  
Mustafa Elgasim ◽  
Anoop Rehal ◽  
Bee K Tan

This article reports a case of SARS-CoV-2 infection complicated by intrahepatic cholestasis of pregnancy in the second trimester in a South Asian woman. She presented with itchiness and grossly elevated bile acid following SARS-CoV-2 virus infection. Her cholestasis resolved in parallel with her infection while she was being treated with ursodeoxycholic acid. Bile acid is considered harmful to a developing fetus and is associated with adverse pregnancy outcomes, particularly stillbirth. Ursodeoxycholic acid is still commonly used in the treatment of these patients despite controversy about its value. It has anti-inflammatory properties and there have been suggestions that this could benefit patients with SARS-CoV-2. Elevated levels of primary bile acids (cholic and chenodeoxycholic acid) are considered harmful to a developing fetus, and are associated with adverse pregnancy outcomes, in particular, stillbirth. The secondary bile acid, ursodeoxycholic acid, is thought to be beneficial by reducing cholesterol production in the liver. This clinical case study highlights a diagnostic enigma in the management of this unique clinical case presentation.


Author(s):  
Sangeeta Yadav ◽  
Amit Goel ◽  
Raghavendra Lingaiah ◽  
Mandakini Pradhan ◽  
Harshita Katiyar ◽  
...  

Author(s):  
Bhawna Sharma ◽  
Neetu Arora ◽  
Kusum Dogra ◽  
Kamal S. Negi

Background: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period in a tertiary care centre.Methods: Data from 1 January to 31 December 2017 were collected to identify parturients with ICP.Results: Almost 3/4th of births came to a vaginal delivery (76.74%) and only 10 parturients had cesarean delivery. 4 of 10 parturients underwent nonelective cesarean section, while 6 had elective cesarean delivery. 15.15 % vaginal deliveries were instrumental. The most common indications for emergency LSCS and instrumental deliveries was fetal distress followed by failure to progress of labour. Most births occurred at or after 37 weeks of gestation (65%).  Regarding neonatal outcomes in terms of birth weight and Apgar scores at 1 and 5 min, they were positive, as well.  None of the babies had Apgar score < 7 at 5 minutes. No case of perinatal death was observed.Conclusions: Although the results were generally positive, larger studies need to be conducted to evaluate the maternal and fetal outcomes in ICP and correlation with serum bile acid levels.


Author(s):  
Wojciech Jelski ◽  
Joanna Piechota ◽  
Karolina Orywal ◽  
Barbara Mroczko

Introduction: Intrahepatic cholestasis of pregnancy (ICP) is the liver disorder in the second or early third trimester of pregnancy. It is characterized by pruritus with increased serum bile acids concentration and other liver function tests. ICP  is connected with increased risk of fetal mortality, but is unfortunately detected quite late. Therefore, it is important to recognize the disease in its early stages. We aimed to investigate the serum alcohol dehydrogenase (ADH) activity and compare it with the concentration of total bile acid (TBA) in women with ICP. Methods: Serum samples were taken for routine investigation from 80 pregnancies with ICP in the second or third trimester of pregnancy and from 80 healthy pregnant women in the same time of pregnancy. For measurement of class I activity we used the spectrofluorometric methods. The total ADH activitiy was measured by the photometric method. Results: The analysis of results shows a statistically significant increase in the activity of ADH I and ADH total (about 60% and 41.3%, respectively). Activity of ADH I well correlated with aminotransferases (alanine ALT and aspartate AST) and total bile acids (TBA) concentration. The total ADH activity was also positively correlated with ALT, AST and total bile acids. Conclusion: We can state that the activity of class I alcohol dehydrogenase isoenzyme in the sera of patients with ICP is increased and seems to be a good indicator of liver cell destruction during this disease and is comparable with the value of other markers.


2018 ◽  
Vol 06 (06) ◽  
pp. 42-52
Author(s):  
Feng Xie ◽  
Xiaofeng Liu ◽  
Ping Xiao ◽  
Yang Huang ◽  
Qiaobing Chen ◽  
...  

2011 ◽  
Vol 112 (3) ◽  
pp. 250-251 ◽  
Author(s):  
Dalia Baliutavičienė ◽  
Nijolė Zubruvienė ◽  
Rimantas Žalinkevičius

2020 ◽  
Vol 319 (2) ◽  
pp. G197-G211
Author(s):  
Vanessa Pataia ◽  
Saraid McIlvride ◽  
Georgia Papacleovoulou ◽  
Caroline Ovadia ◽  
Julie A. K. McDonald ◽  
...  

We used a mouse model of gestational hypercholanemia to investigate the use of obeticholic acid (OCA), a potent FXR agonist, as a treatment for the hypercholanemia of intrahepatic cholestasis of pregnancy (ICP). The results demonstrate that OCA can improve the fetal bile acid profile. This is relevant not only to women with ICP but also for women who become pregnant while receiving OCA treatment for other conditions such as primary biliary cholangitis and nonalcoholic steatohepatitis.


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