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 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.

scholarly journals The Comparison of Total Bile Acid Concentration and Alcohol Dehydrogenase Activity as Markers of Intrahepatic Cholestasis of Pregnancy

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

Abstract Background: 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 total bile acids concentration (TBA) and increased liver enzymes. It is important to recognize the disease in its early stage. 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 from 80 pregnancies with ICP in the second or third trimester of pregnancy and from 80 healthy pregnant women. For measurement of ADH we used the spectrofluorometric and photometric methods. Results: The results shows a statistically significant increase in the activity of ADH I and ADH total (about 60% and 41%, respectively). Activity of ADH I well correlated with aminotransferases (alanine ALT and aspartate AST) and TBA concentration. The total ADH activity was also positively correlated with ALT, AST and TBA. Conclusion: We can state that the activity of class I ADH isoenzyme in the sera of patients with ICP is increased and seems to be a good indicator of liver cell destruction during ICP and is comparable with the value of other markers.

scholarly journals Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

2021 ◽  
Vol 81 (08) ◽  
pp. 922-939
Author(s):  
Carsten Hagenbeck ◽  
Amr Hamza ◽  
Sven Kehl ◽  
Holger Maul ◽  
Frank Lammert ◽  
...  
Keyword(s):  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Perinatal Outcomes ◽  
Fetal Monitoring ◽  
Fetal Outcome ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Bile Acid Level ◽  
Cardinal Symptom ◽  
Cholestasis Of Pregnancy ◽  
Meconium Stained Amniotic Fluid

AbstractIntrahepatic cholestasis of pregnancy (ICP) is the most common liver disease specific to pregnancy. The cardinal symptom of pruritus and a concomitant elevated level of bile acids in the serum and/or alanine aminotransferase (ALT) are suggestive for the diagnosis. Overall, the maternal prognosis is good. The fetal outcome depends on the bile acid level. ICP is associated with increased risks for adverse perinatal outcomes, including preterm delivery, meconium-stained amniotic fluid, and stillbirth. Acute fetal asphyxia and not chronic uteroplacental dysfunction leads to stillbirth. Therefore, predictive fetal monitoring is not possible. While medication with ursodeoxycholic acid (UDCA) improves pruritus, it has not been shown to affect fetal outcome. The indication for induction of labour depends on bile acid levels and gestational age. There is a high risk of recurrence in subsequent pregnancies.

scholarly journals Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization

2017 ◽  
Vol 7 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Filiz F Bolukbas ◽  
Cengiz Bolukbas ◽  
Hatice Y Balaban ◽  
Cem Aygun ◽  
Seyda Ignak ◽  
...  
Keyword(s):  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Multiple Pregnancy ◽  
Onset Time ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Limited Information ◽  
Singleton Pregnancy ◽  
Cholestasis Of Pregnancy

ABSTRACT Aim Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/spontaneous pregnancy. Materials and methods We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results. Results We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = −0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count. Conclusion Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP. How to cite this article Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.

Sign in / Sign up

Export Citation Format

Share Document