Maternal bile acid profile and subtype analysis of intrahepatic cholestasis of pregnancy

Abstract Background ICP pregnant women have a unique profile of serum bile acid metabolism, thus the early and accurate identification of ICP patients is beneficial to early appropriate treatment and improvement of pregnancy outcomes. In this study, ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS) was used to analyze the 15 types of serum bile acid profiles among patients with ICP in third trimester, patients with cholelithiasis, and patients with hepatitis B virus. The ICP diagnostic model established by partial least squares-discriminant analysis (PLS-DA) was used to screen the differential bile acids for clinical subtypes of ICP. 144 cases of ICP patients were involved in this study, and divided into four subgroups according to serum level of TBA, DBIL, and ALT. Results (1) The differential serum bile acid profiles of ICP group and normal pregnant women were DCA, TDCA, TCA, GDCA and GLCA. (2) The differential serum bile acid profiles of the ICP1 group (ICP with jaundice) and normal pregnant women were TCDCA, TCA, GCA, GCDCA, TUDCA and GUDCA. (3) The differential serum bile acid profiles of the ICP3 group (Hyperchoicemia of pregnancy) and normal pregnant group was GUDCA, LCA, GLCA, UDCA, TUDCA, CDCA, and TLCA (P < 0.05). (4) The differential serum bile acid profiles of ICP4 group (idiopathic aminotransferase abnormality during pregnancy) and normal pregnant group was UDCA, GUDCA, TUDCA, GCA and GLCA (P < 0.05). (5) The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP1 group was significantly higher than normal group, ICP2 group, ICP3 group, and ICP4 group (P < 0.05); The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP2 group, ICP3 group, and ICP4 group was significantly higher than normal group (P < 0.05), but no difference was found among ICP2 group, ICP3 group, and ICP4 group (P > 0.05). Conclusion Maternal serum bile acid profiles are useful to differentiate the four subtypes of ICP. ICP with jaundice could be an important predictor of adverse pregnancy outcomes of ICP.

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Maternal bile acid profile and subtype analysis of intrahepatic cholestasis of pregnancy

10.21203/rs.3.rs-18812/v1 ◽

2020 ◽

Author(s):

yong shao ◽

Huan Li ◽

Qing Tang ◽

Di Xu ◽

Siyu Chen

Keyword(s):

Mass Spectrometry ◽

Bile Acid ◽

Cesarean Section ◽

Amniotic Fluid ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Premature Delivery ◽

Serum Bile Acid ◽

Bile Acid Profiles ◽

Meconium Stained Amniotic Fluid

Abstract Background ICP pregnant women have a unique profile of serum bile acid metabolis, early and accurate identification of ICP patients is beneficial to early appropriate treatment and improvement of pregnancy outcomes. In this study, ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS) was used to analyze the 15 types of serum bile acid profiles of ICP in third trimester, patients with cholelithiasis, and patients with hepatitis B virus. The ICP diagnostic model established by partial least squares-discriminant analysis (PLS-DA) was used to screen the differential bile acids for clinical subtypes of ICP. 144 cases of ICP patients were involved in this study, and were divided into four subgroups according to serum levels of TBA, DBIL, and ALT. Results ①The differential serum bile acid profiles of ICP group and normal pregnant women were DCA, TDCCA, TCA, GDCA and GLCA.②The differential serum bile acid profiles of the ICP1 group (ICP with jaundice) and normal pregnant women were TCDCA, TCA, GCA, GCDCA, TUDCA and GUDCA.③The differential serum bile acid profiles of the ICP3 group (hyperbiliary acidemia of pregnancy) and normal pregnant group was GUDCA, LCA, GLCA, UDCA, TUDCA, CDCA, and TLCA (P <0.05).④The differential serum bile acid profiles of ICP4 group (idiopathic aminotransferase abnormality during pregnancy) and normal pregnant group was UDCA, GUDCA, TUDCA, GCA and GLCA (P <0.05).⑤The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP1 group was significantly higher than normal group,ICP2 group,ICP3 group,and ICP4 group (P <0.05); The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP2 group, ICP3 group,and ICP4 group was significantly higher than normal group (P <0.05), but no difference was found among ICP2 group, ICP3 group,and ICP4 group (P> 0.05). Conclusion: Maternal serum bile acid profiles are useful to differentiate the four subtypes of ICP. ICP with jaundice could be an important predictor of adverse pregnancy outcomes of ICP.

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Maternal bile acid profile and subtype analysis of intrahepatic cholestasis of pregnancy

10.21203/rs.3.rs-18812/v2 ◽

2020 ◽

Author(s):

Yong Shao ◽

Siyu Chen ◽

Huan Li ◽

Qing Tang ◽

Di Xu

Keyword(s):

Mass Spectrometry ◽

Bile Acid ◽

Cesarean Section ◽

Amniotic Fluid ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Premature Delivery ◽

Serum Bile Acid ◽

Bile Acid Profiles ◽

Meconium Stained Amniotic Fluid

Abstract Background ICP pregnant women have a unique profile of serum bile acid metabolism, thus the early and accurate identification of ICP patients is beneficial to early appropriate treatment and improvement of pregnancy outcomes. In this study, ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS) was used to analyze the 15 types of serum bile acid profiles among patients with ICP in third trimester, patients with cholelithiasis, and patients with hepatitis B virus. The ICP diagnostic model established by partial least squares-discriminant analysis (PLS-DA) was used to screen the differential bile acids for clinical subtypes of ICP. 144 cases of ICP patients were involved in this study, and divided into four subgroups according to serum level of TBA, DBIL, and ALT.Results ①The differential serum bile acid profiles of ICP group and normal pregnant women were DCA, TDCA, TCA, GDCA and GLCA.②The differential serum bile acid profiles of the ICP1 group (ICP with jaundice) and normal pregnant women were TCDCA, TCA, GCA, GCDCA, TUDCA and GUDCA.③The differential serum bile acid profiles of the ICP3 group (Hyperchoicemia of pregnancy) and normal pregnant group was GUDCA, LCA, GLCA, UDCA, TUDCA, CDCA, and TLCA (P <0.05).④The differential serum bile acid profiles of ICP4 group (idiopathic aminotransferase abnormality during pregnancy) and normal pregnant group was UDCA, GUDCA, TUDCA, GCA and GLCA (P<0.05).⑤The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP1 group was significantly higher than normal group,ICP2 group,ICP3 group,and ICP4 group (P<0.05); The occurrence of meconium-stained amniotic fluid, premature delivery and cesarean section in ICP2 group, ICP3 group, and ICP4 group was significantly higher than normal group (P<0.05), but no difference was found among ICP2 group, ICP3 group, and ICP4 group (P> 0.05).Conclusion: Maternal serum bile acid profiles are useful to differentiate the four subtypes of ICP. ICP with jaundice could be an important predictor of adverse pregnancy outcomes of ICP.

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Bile Acid Profiles of Human Serum and Skin Interstitial Fluid and Their Relationship to Pruritus Studied by Gas Chromatography–Mass Spectrometry

Clinical Science ◽

10.1042/cs0630065 ◽

1982 ◽

Vol 63 (1) ◽

pp. 65-73 ◽

Cited By ~ 66

Author(s):

T. C. Bartholomew ◽

J. A. Summerfield ◽

B. H. Billing ◽

A. M. Lawson ◽

K. D. R. Setchell

Keyword(s):

Mass Spectrometry ◽

Gas Chromatography ◽

Bile Acid ◽

Bile Acids ◽

Interstitial Fluid ◽

Gas Chromatography Mass Spectrometry ◽

Serum Bile Acid ◽

Causative Role ◽

Chromatography Mass Spectrometry ◽

Bile Acid Profiles

1. Pruritus was assessed in 19 patients by measurement of nocturnal limb movement. 2. Serum (nine pruritic, ten non-pruritic) and interstitial fluid (five pruritic, three non-pruritic) bile acids were fractionated according to their mode of conjugation by using DEAP-Sephadex LH-20 and measured by gas chromatography—mass spectrometry. 3. No correlation was found between serum or interstitial fluid total bile acid or individual bile acid concentrations and pruritus. Bile acid profiles in the two groups of patients were similar and there was no correlation between pruritus and the conjugation pattern. 4. The bile acid profile of interstitial fluid reflected that of serum and a linear relationship was found between serum and interstitial fluid bile acid concentrations (r = 0·95, P < 0·001). 5. The proportion of bile acid sulphate in interstitial fluid was significantly smaller than that in serum (P < 0·025), where sulphates accounted for up to 46% of the total bile acids. 6. In three patients, a decrease in serum bile acid concentrations achieved by percutaneous transhepatic biliary drainage had little or no effect on pruritus. 7. These findings suggest that bile acids do not have a causative role in the pruritus of cholestatic liver disease.

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Meconium Stained Amniotic Fluid and Risk of Post Cesarean Section Surgical Site Infection

Strad Research ◽

10.37896/sr8.7/039 ◽

2021 ◽

Vol 8 (7) ◽

Keyword(s):

Cesarean Section ◽

Amniotic Fluid ◽

Surgical Site Infection ◽

Site Infection ◽

Meconium Stained Amniotic Fluid

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Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205443 ◽

2020 ◽

Vol 10 (1) ◽

pp. 107

Author(s):

Vandana Mohapatra ◽

Sujata Misra ◽

Tapas Ranjan Behera

Keyword(s):

Caesarean Section ◽

Amniotic Fluid ◽

Pregnant Women ◽

Perinatal Outcome ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Control Group ◽

Study Group ◽

The Mean ◽

Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction. Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

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Potential Implications for Monitoring Serum Bile Acid Profiles in Circulation with Serum Proteome for Carbon Tetrachloride-Induced Liver Injury/Regeneration Model in Mice

Journal of Proteome Research ◽

10.1021/pr1002388 ◽

2010 ◽

Vol 9 (9) ◽

pp. 4490-4500 ◽

Cited By ~ 17

Author(s):

Takashi Shimada ◽

Tsuyoshi Nakanishi ◽

Atsuhiko Toyama ◽

Satoshi Yamauchi ◽

Atsuhiro Kanzaki ◽

...

Keyword(s):

Bile Acid ◽

Carbon Tetrachloride ◽

Liver Injury ◽

Serum Bile Acid ◽

Serum Proteome ◽

Bile Acid Profiles

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Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0428 ◽

2019 ◽

Vol 47 (6) ◽

pp. 611-618

Author(s):

Eviatar Naamany ◽

Irit Ayalon-Dangur ◽

Eran Hadar ◽

Iftach Sagy ◽

Dafna Yahav ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Retrospective Cohort Study ◽

Pregnancy Outcomes ◽

Retrospective Cohort ◽

Urine Culture ◽

Premature Delivery ◽

Positive Urine Culture ◽

Positive Urine ◽

Adverse Pregnancy

Abstract Background The association between bacteriuria and adverse pregnancy outcomes has been extensively described. The current practice of screening all pregnant women for bacteriuria is challenged by recent studies. We aimed to evaluate pregnancy outcomes among women with a positive urine culture, to assess the significance of positive urinary nitrites in this setting. Methods This was a retrospective cohort study at the emergency department (ED) of the Helen Schneider Hospital for Women, Israel, during 2014–2018. This included all gravida women >18 years old within the 20th week of pregnancy or above, admitted to the ED with diverse complains, who had urinalysis collected and subsequently had a positive urine culture. Clinical and obstetric characteristics were stratified by positive vs. negative nitrites in urinalysis. The primary outcome was premature delivery, and the secondary outcomes were a composite outcome of all recorded pregnancy complications and the significance of urinalysis in predicting urinary tract infection (UTI). Results Overall, 874 pregnant women with a positive urine culture were included. Of them, 721 (79%) patients had a negative nitrite in their urine exam (NNU-group) and 153 (21%) had a positive nitrite in their urine exam (PNU-group). Escherichia coli was the most common pathogen, with significantly higher rates of growth in the PNU-group vs. NNU-group [129 (84.3%) vs. 227 (38.4%), P < 0.001]. Premature delivery was recorded with no association of symptomaticity or nitrite status. Among symptomatic women with classic symptoms of UTI, PNU was significantly associated with decreased risk for major peripartum complications [odds ratio (OR) with 95% confidence interval (CI) of 0.22 (0.05–0.94)]. Conclusion Our findings support that PNU among symptomatic pregnant women with UTI-related symptoms was associated with lower risk of developing major adverse obstetrical outcomes.

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