scholarly journals Value of Serum Glycocholic Acid and Total Bile Acids in Predicting Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Chong Fu ◽  
Yali Xu
Keyword(s):  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Diagnostic Value ◽  
Control Group ◽  
Observation Group ◽  
Glycocholic Acid ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Objective. To see whether serum glycocholic acid (CG) and total bile acids (TBA) can predict maternal and perinatal outcomes in pregnant women with intrahepatic cholestasis (ICP). Method. The observation group consisted of 80 women with ICP who were treated in our hospital, whereas the control group consisted of 50 ordinary women who were also treated at our hospital at the same time. The levels of CG and TBA in the two groups were determined independently, and the differences in poor perinatal outcomes were compared. Finally, the predictive diagnostic value of CG and TBA for poor perinatal outcomes in ICP mothers was displayed using the Spearman correlation between CG and TBA and Apgar. The maternal CG and TBA levels in the observation group were substantially higher than in the control group (P0.05). The observation group had more significant maternal-fetal discomfort, neonatal asphyxia, preterm birth, and perinatal death than the control group (P0.05). The risk of poor perinatal outcomes in ICP mothers rose when TBA and CG levels increased (P0.05). Apgar ratings were inversely associated with CG and TBA (r = −0.8251 and r = −0.5969, respectively, P0.05). The CG and TBA diagnostic AUCs for unfavorable perinatal outcomes in ICP mothers were (P0.05). Conclusion. CG and TBA have a high diagnostic value for ICP and may better predict and identify poor prenatal outcomes. It is suitable for clinical use.

scholarly journals The comparison of total bile acid concentration and alcohol dehydrogenase activity as markers of intrahepatic cholestasis of pregnancy

2021 ◽  
Author(s):  
Wojciech Jelski ◽  
Joanna Piechota ◽  
Karolina Orywal ◽  
Barbara Mroczko
Keyword(s):  
Bile Acid ◽  
Alcohol Dehydrogenase ◽  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Total Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Third Trimester ◽  
Total Bile Acids ◽  
Adh Activity ◽  
Cholestasis Of Pregnancy

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.

scholarly journals Influence of severity of total bile acids and mode of delivery on the perinatal outcomes in intrahepatic cholestasis of pregnancy

2021 ◽  
Author(s):  
Chengcai Kong ◽  
Fenglin Mei ◽  
Pingping Xue ◽  
Jingyun Cao ◽  
Yong Li ◽  
...  
Keyword(s):  
Bile Acids ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Intrahepatic Cholestasis ◽  
Mode Of Delivery ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Abstract To assess the associations between mode of delivery and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP) based on the severity of maternal hypercholanemia. A hospital-based retrospective cohort study was performed between January 1, 2015, and December 31, 2019. Among the 177 women with mild total bile acids, 123 (69.5%) had a vaginal delivery and 54 (30.5%) underwent a cesarean delivery, of which 42 (23.7%) were planned and 12 (6.8%) were unplanned. Among the 50 severe ICP women, 13 (26.0%) had a vaginal delivery and 37 (74.0%) underwent a cesarean delivery, of which 26 (52.0%) were planned and 11 (22.0%) were unplanned. Severe ICP was associated with an increased risk of preterm delivery (P < 0.001), low birthweight (P=0.001), and neonatal intensive care unit admission (P < 0.001). Women with severe ICP (aOR, 5.017; 95% CI 1.848–13.622), planned cesarean delivery (aOR, 5.444; 95%CI 1.723–17.203), or unplanned cesarean delivery (aOR, 5.792; 95%CI 1.384–24.236) had increased risks of adverse fetal outcomes compared to controls. Both planned and unplanned cesarean delivery are associated with a higher incidence of adverse fetal outcomes and severe ICP than vaginal delivery.

scholarly journals Maternal and fetal outcome in intrahepatic cholestasis of pregnancy at tertiary care institute of North India

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Sunita Arora ◽  
Anju Huria ◽  
Poonam Goel ◽  
Jasbinder Kaur ◽  
Sunita Dubey
Keyword(s):  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Liver Enzymes ◽  
Tertiary Care ◽  
Population History ◽  
Whole Body ◽  
Control Group ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Initial Visit ◽  
Cholestasis Of Pregnancy

Objectives: Intrahepatic cholestasis of pregnancy (IHCP) is the most common reversible form of hepatic disease in pregnancy. The risk of sudden intrauterine infant death is major threat as none of the fetal monitoring proved effective for its prevention. This study was conducted to know the prevalence of IHCP along with fetal and maternal outcome in North Indian population. Material and Methods: This case–control study was conducted over a period of 6 months. One hundred pregnant patients were recruited in each group. Patients with IHCP were included in case group whereas apparently healthy pregnant women with singleton pregnancy were included in control group. Bile acids were done only once at the time of initial visit whereas liver enzymes were done at initial visit and subsequently weekly for total 3 times. All cases of IHCP were started on ursodeoxycholic acid (UDCA) with a dose of 10–15 mg/kg/day throughout pregnancy and three doses of 10 mg Vitamin K by intramuscular route were also given. Fetal and maternal outcomes were compared between both the groups. Total numbers of deliveries in that time period were also noted to find out the prevalence of disease. The tests of two or more proportions were done using Fisher’s exact test and Chi-square test. P < 0.05 was considered statistically significant. Results: The prevalence of IHCP was 4.08% in our population, however, women from urban area had higher incidence of cholestasis than rural population. History of recurrent disease was found in 30% of women. Out of 100, 96% presented with itching and only 57–58% had raised liver enzymes levels. In 89% of patients (89/100), bile acids levels were >14 μmol/l. During follow-up, SGOT and SGPT levels were significantly improved over 2-week interval while on treatment with UDCA; however, levels were still on higher side. There was no correlation found between cholestasis of pregnancy with preterm labor and meconium-stained liquor in the present study. Comparable results were found in terms of respiratory distress syndrome and NICU admission, whereas significant high incidence of neonatal jaundice found in the control group. Conclusion: Itching over whole body was the predominant presenting complaints of cholestasis of pregnancy. Diagnosis should be supported by bile acids in women with normal liver enzymes to decrease the cost of investigations. Early termination of pregnancy between 36 and 37 weeks can be considered in women with bile acids >40 μmol/L and in non-compliant patients on UDCA treatment.

Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids ≥100 µmol/L

2020 ◽  
Vol 135 ◽  
pp. 155S-156S
Author(s):  
Zoe C. Frank ◽  
Mary N. Nienow-Birch ◽  
Jamie Lo ◽  
Brian L. Shaffer ◽  
Aaron B. Caughey
Keyword(s):  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids 40–99 µmol/L

2020 ◽  
Vol 135 ◽  
pp. 156S
Author(s):  
Zoe C. Frank ◽  
Mary N. Nienow-Birch ◽  
Jamie Lo ◽  
Brian L. Shaffer ◽  
Aaron B. Caughey
Keyword(s):  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

scholarly journals Intrahepatic Cholestasis of Pregnancy with Adverse Perinatal Outcomes

2019 ◽  
pp. 78-84
Author(s):  
Ya. I. Bik-Mukhametova ◽  
T. N. Zakharenkova
Keyword(s):  
Intrahepatic Cholestasis ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Perinatal Period ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Severe Respiratory Distress ◽  
Insufficient Amount ◽  
Meconium Staining ◽  
Severe Respiratory Distress Syndrome ◽  
Cholestasis Of Pregnancy

Intrahepatic cholestasis of pregnanсу is the most common liver pathology in pregnant women. This disease has complex multifactorial pathogenesis, which is based on a genetic predisposition, insufficient amount of selenium in food and an incorrect reaction of a pregnant woman's body to a normal or elevated level of sex hormones and their metabolites. The main clinical manifestation is skin itching without skin rash. Intrahepatic cholestasis of pregnanсy leads to the development of pregnancy complications, such as preterm labour, often accompanied by meconium staining of amniotic fluid. In newborns, regardless of the gestational age, it contributes to the development of severe respiratory distress syndrome. These complications during pregnancy and the perinatal period are accompanied by high perinatal morbidity and mortality. This article describes three cases of pregnancy complicated by intrahepatic cholestasis, with early neonatal death of newborns. An indepth study and identification of the possible predictors of perinatal death of newborns from mothers with intrahepatic cholestasis of pregnancy will prevent negative outcomes in the future.

scholarly journals Diagnostic Value of Vaginal Microecology, Serum miR-18a, and PD-L1 for Identifying HPV-Positive Cervical Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382199528
Author(s):  
Yumei Zhang ◽  
Sujuan Qiu ◽  
Yueli Guo ◽  
Jiaqin Zhang ◽  
Xiaoqing Wu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
High Serum ◽  
Control Group ◽  
Observation Group ◽  
Positive Group ◽  
Microbial Dysbiosis ◽  
Programmed Death

Objective: We aimed to investigate the diagnostic value of the vaginal microecology, serum miR-18a, and programmed death ligand-1 (PD-L1) for human papillomavirus (HPV)-positive cervical cancer. Methods: Eighty-four patients with HPV-positive cervical cancer were assigned to the observation group, 107 HPV-positive patients without cervical cancer were assigned to the positive group, and 191 healthy women were assigned to the control group. Vaginal microecology and serum levels of miR-18a and PD-L1 on the surface of CD4+ and CD8+ T cells were compared among the 3 groups. The observation group was further divided into subgroups according to patients’ characteristics for comparison. The diagnostic value of miR-18a and PD-L1 for HPV-positive cervical cancer was investigated. Results: Women in the control group had better vaginal microecology and lower levels of miR-18a and PD-L1 than those in the observation and the positive groups (all P < 0.05). Compared with the positive group, the observation group had similar vaginal microecology (all P > 0.05) but higher levels of miR-18a and PD-L1 (all P < 0.05). Moreover, the patients at stage III had higher levels of miR-18a and PD-L1 than those at stage I and II (all P < 0.05). The values of area under the curve for miR-18a and PD-L1 in the diagnosis of HPV-positive cervical cancer were over 0.8 (all P < 0.001). Conclusion: Patients with HPV-positive cervical cancer have vaginal microbial dysbiosis and high serum levels of miR-18a and PD-L1. miR-18a and PD-L1 have diagnostic value for identifying HPV-positive cervical cancer.

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