scholarly journals Intrahepatic Cholestasis of Pregnancy

2021 ◽  
Vol 81 (08) ◽  
pp. 940-947
Author(s):  
Stanisław M. Jurk ◽  
Andreas E. Kremer ◽  
Ekkehard Schleussner
Keyword(s):  
Intrahepatic Cholestasis ◽  
Elevated Serum ◽  
Serum Levels ◽  
Intrauterine Death ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Perinatal Morbidity ◽  
Bile Acid Concentration ◽  
Intense Pruritus ◽  
Cholestasis Of Pregnancy

AbstractIntrahepatic cholestasis of pregnancy (ICP) is a rare but potentially serious complication of pregnancy, the main symptom of which is intense pruritus with elevated serum levels of bile acids. The elevated serum bile acid concentration is regarded as a predictor for poor perinatal outcome including intrauterine death. Ursodeoxycholic acid (UDCA) has become established as the treatment of choice in clinical management to achieve a significant improvement in symptoms and reduce the cholestasis. Pregnant women with severe intrahepatic cholestasis should always be managed in a perinatal centre with close interdisciplinary monitoring and treatment involving perinatologists and hepatologists to minimise the markedly increased perinatal morbidity and mortality as well as maternal symptoms.

scholarly journals Seasonal Impact in the Frequency of Intrahepatic Cholestasis of Pregnancy

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Cem Yaşar Sanhal ◽  
Korkut Dağlar ◽  
Özgür Kara ◽  
Ayşe Kırbaş ◽  
Dilek Uygur ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intrahepatic Cholestasis ◽  
Elevated Serum ◽  
Cumulative Risk ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Chi Square ◽  
Serum Aminotransferase ◽  
Bile Acid Concentration ◽  
Cholestasis Of Pregnancy

<p>Objective: To evaluate the presence of any seasonal variation in the frequency of intrahepatic cholestasis of pregnancy (ICP).<br />Study Design: A total of 126 cases with ICP were compared with a cohort of 37614 pregnant women who delivered. The diagnosis ICP was performed on the basis of severe itching and the absence of dermal rash and any other hepatic disease, with the co-existence of elevated serum aminotransferase levels and/or serum bile acid concentration. For each month and season, observed and expected ICP rates were analysed and compared by using chi-square statistics. Multivariate logistic regression was performed to investigate certain parameters on cumulative risk. <br />Results: A significantly lower frequency of ICP in winter (6/126 (4.8%), p=0.001) and a significantly higher frequency in spring (44/126 (34.9%), p=0.034) were detected. A 2.1 and 3.8-fold higher risk were found for the nulliparity and the twin pregnancy, respectively. Logistic regression analysis confirmed the significant (10-fold) decrease in the frequency of ICP in winter. The significance of spring did not persist after the adjustment.<br />Conclusion: Main outcome of the study points at seasonality in ICP frequency. Future studies in different populations may reveal data about factors that interact with seasonality and playing roles in ICP. <br /><br /></p>

Molecular pathogenesis of intrahepatic cholestasis of pregnancy

2008 ◽  
Vol 10 ◽  
Author(s):  
Marco Arrese ◽  
Rocio I.R. Macias ◽  
Oscar Briz ◽  
Maria J. Perez ◽  
Jose J.G. Marin
Keyword(s):  
Intrahepatic Cholestasis ◽  
Molecular Level ◽  
Current Knowledge ◽  
Elevated Serum ◽  
Transport Proteins ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Secretory Function ◽  
Third Trimester ◽  
Cholestasis Of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) occurs mainly in the third trimester and is characterised by pruritus and elevated serum bile acid levels. ICP is associated with an increased perinatal risk and higher rates of foetal morbidity and mortality. Although the pathogenesis of this disease is unknown, a genetic hypersensitivity to female hormones (oestrogen and/or progesterone) or their metabolites is thought to impair bile secretory function. Recent data suggest that mutations or polymorphisms of genes expressing hepatobiliary transport proteins or their nuclear regulators may contribute to the development and/or severity of ICP. Unidentified environmental factors may also influence pathogenesis of the disease. This review summarises current knowledge on the potential mechanisms involved in ICP at the molecular level.

scholarly journals Acidosis: A potential explanation for adverse fetal outcome in intrahepatic cholestasis of pregnancy. A case report

2014 ◽  
Vol 7 (4) ◽  
pp. 177-179 ◽  
Author(s):  
K Sterrenburg ◽  
W Visser ◽  
LS Smit ◽  
J Cornette
Keyword(s):  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Fetal Outcome ◽  
Maternal Serum ◽  
Gas Analysis ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Bile Acid Concentration ◽  
Increased Risk ◽  
Cholestasis Of Pregnancy

Background Intrahepatic cholestasis of pregnancy is a cholestatic disorder with an increased risk for adverse perinatal outcome. The mechanism underlying intrauterine demise is poorly understood. Case A nulliparous woman with gestational age of 36 plus 6 weeks presented with suspected intrahepatic cholestasis. Continuous CTG monitoring evolved from a normal pattern towards a non-reassuring pattern. A male neonate was delivered by caesarean section. Apgar scores 0, 1 and 4 at 1, 5 and 10 min. Fetal cord gas analysis showed pH 6.98, base deficit –15 mmol/L. Blood results showed maternal serum bile acid concentration of 220 µmol/L. Conclusion Our case suggests gradual evolution towards hypoxia and acidosis. It is unknown whether certain components in the bile acid concentrations might contribute to a fetal metabolic component of the acidosis.

Development of a disposable bile acid biosensor for use in the management of cholestasis

2015 ◽  
Vol 7 (9) ◽  
pp. 3714-3719 ◽  
Author(s):  
D. Lawrance ◽  
C. Williamson ◽  
M. G. Boutelle ◽  
A. E. G. Cass
Keyword(s):  
Bile Acid ◽  
Acid Concentration ◽  
Intrahepatic Cholestasis ◽  
Liver Diseases ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Bile Acid Concentration ◽  
Cholestasis Of Pregnancy

Measurement of serum bile acid concentration is a valuable tool for the management of intrahepatic cholestasis of pregnancy (ICP) and is also useful in the monitoring of other liver diseases.

scholarly journals Serum bile acid levels in women with intrahepatic cholestasis of pregnancy in India

2021 ◽  
Author(s):  
Sangeeta Yadav ◽  
Amit Goel ◽  
Raghavendra Lingaiah ◽  
Mandakini Pradhan ◽  
Harshita Katiyar ◽  
...  
Keyword(s):  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Cholestasis Of Pregnancy

scholarly journals The molecular genetics of intrahepatic cholestasis of pregnancy

2008 ◽  
Vol 1 (2) ◽  
pp. 65-71 ◽  
Author(s):  
P H Dixon ◽  
C Williamson
Keyword(s):  
Molecular Genetics ◽  
Intrahepatic Cholestasis ◽  
Genetic Factors ◽  
Preterm Labour ◽  
Intrauterine Death ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Liver Impairment ◽  
Cholestasis Of Pregnancy ◽  
Shed Light

Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, causes maternal pruritus and liver impairment, and may be complicated by spontaneous preterm labour, fetal asphyxial events and intrauterine death. Our understanding of the aetiology of this disease has expanded significantly in the last decade due to a better understanding of the role played by genetic factors. In particular, advances in our knowledge of bile homeostasis has led to the identification of genes that play a considerable role in susceptibility to ICP. In this review we consider these advances and discuss the disease in the context of bile synthesis and metabolism, focusing on the genetic discoveries that have shed light on the molecular aetiology and pathophysiology of the condition.

scholarly journals Intrahepatic cholestasis of pregnancy: maternal and fetal outcome and its correlation with serum bile acid levels

2018 ◽  
Vol 7 (11) ◽  
pp. 4403
Author(s):  
Bhawna Sharma ◽  
Neetu Arora ◽  
Kusum Dogra ◽  
Kamal S. Negi
Keyword(s):  
Bile Acid ◽  
Cesarean Delivery ◽  
Intrahepatic Cholestasis ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Vaginal Deliveries ◽  
Cholestasis Of Pregnancy

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.

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