scholarly journals Critical Level of Alanine Transaminase to Predict Foetomaternal Outcome in Intrahepatic Cholestasis of Pregnancy: A Case-control Study

Author(s):  
Nidhi Ahuja ◽  
Anjali Dabral ◽  
Sheeba Marwah ◽  
Rekha Bharti ◽  
Deepti Pachauri ◽  
...  

Introduction: Intrahepatic Cholestasis of Pregnancy (IHCP) is a disorder of the second and third trimester causing pruritis without a rash in the women. To avoid the adversities, early delivery is indicated before serum bile acids levels of >40 μmol/L is reached. In the settingswhere bile acid testing is not available, serum transaminases can be used for diagnosis and management of IHCP. Aim: To find out value of Alanine Transaminase (ALT) for the prediction of adverse outcomes. Materials and Methods: This case-control study was carried out from October 2018 to March 2020, enrolled 75 singleton women with IHCP and 75 controls in their third trimester. The diagnosis was based on the presence of pruritis without an identifiable dermatological cause along with raised serum transaminases. Serum ALT levels and the foetomaternal outcomes were noted. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Mann-Whitney test, Chi-square test and Fisher’s exact test were used to compare all variables. The p-value of <0.05 was considered statistically significant. Results: The mean age of women in the IHCP and control groups was 24.81±4.2 and 25.95±5.13 years, respectively and the mean gestational age of women was 34±2.89 weeks. Women with IHCP had increased incidence of induction of labour (p=0.0003) and meconium staining of liquor (p=0.002) as compared to controls. Serum ALT levels showed a significant positive association with meconium staining of liquor (p=0.041), Intrauterine Death (p=0.01), and Neonatal Intensive Care Unit (NICU) admission (p=0.006) in women with IHCP. An ALT value of 133 U/L was found to be predictive of adverse foetal outcomes with sensitivity, specificity and likelihood ratio of 65.7%, 82.5% and 3.76, respectively. Conclusion: IHCP leads to adverse foetal outcomes. But pruritis is the only maternal distress. ALT >133 U/L is predictive of adverse foetal outcome, therefore, termination of pregnancy can be advocated above this level.

2019 ◽  
Vol 156 (6) ◽  
pp. S-1235-S-1236 ◽  
Author(s):  
Erica Monrose ◽  
Andres Ramirez Zamudio ◽  
Alaina Aristide ◽  
Reema Navalurkar ◽  
Rashi Bedekar ◽  
...  

Author(s):  
G. D. Maiti ◽  
Arup Ratan Pal ◽  
Tony Jose ◽  
Monica Saraswat

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common cholestatic liver disease, which may impact the foeto-maternal health. The present study is conducted to determine various factors including maternal and neonatal outcome in IHCP comparing with the controls.Methods: In this prospective case control study, pregnancy with IHCP is compared with asymptomatic non-IHCP controls. Classical pruritus, icterus, elevated liver enzymes were considered in diagnostic criteria of IHCP. Dermatological lesion, acute or chronic liver disease, and other causes of pruritus were excluded from study.Results: Out of 100 patients, 50 cases and 50 controls were included in this study. Incidence of IHCP was seen 3.914% of which 66% were primi presented maximum at 31-33 weeks. 86% of IHCP responded to medication. Mean value of ALT, AST and ALP was found significantly raised (p value-<0.001) in IHCP patients. 66% in IHCP and 64% in non-IHCP group had normal delivery and remaining 34% and 36 % had caesarean delivery respectively. There was no significant increase in foetal distress or low Apgar (<7 at 5 min) at birth or adverse neonatal or maternal outcome in IHCP group. However, there was a statistically high meconium stained liquor (MSL), neonatal jaundice, IUGR and NICU admission were noted in the IHCP group in comparison to non-IHCP group.Conclusions: There is a significant incidence of IHCP in the obstetrical population. The biochemical changes, meconium stained liquor, neonatal jaundice, IUGR and NICU admission were significantly high in IHCP in pregnancy.


1994 ◽  
Vol 170 (3) ◽  
pp. 890-895 ◽  
Author(s):  
Alonso J. Rioseco ◽  
Milenko B. Ivankovic ◽  
Alejandro Manzur ◽  
Fuad Hamed ◽  
Sumie R. Kato ◽  
...  

2013 ◽  
Vol 18 (2) ◽  
pp. 24-26 ◽  
Author(s):  
Razia Sultana ◽  
SM Fazlul Karim ◽  
Farhana Atia ◽  
Shahnila Ferdousi ◽  
Selina Ahmed

Preeclampsia is one of the most leading causes of maternal mortality in developing countries like Bangladesh. Several studies have demonstrated the relationship between platelets count and preeclampsia. The aim of the study was to assess the association of platelets count with preeclampsia. A case control study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011. A total number of 100 pregnant women in third trimester of pregnancy attending in Obstetrics & Gynaecology Department of Dhaka Medical Hospital were selected as study subjects. Among them 50 diagnosed cases of preeclampsia were selected as cases and 50 normal healthy pregnant women as controls. Platelet count was measured in all study subjects. The mean platelet count in cases and controls were 1,44,260±96,472 and 1,98,100±51,219 respectively. The present study showed significant difference of mean platelet count between cases and controls. The study revealed that low platelets count is associated with preeclampsias. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16018 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 24-26


2018 ◽  
Vol 15 (1) ◽  
pp. 74-78
Author(s):  
Mohammadali Nazarinia ◽  
Asghar Zare ◽  
Mohammad javad Fallahi ◽  
Mesbah Shams

Background:Systemic sclerosis is a disorder of connective tissue with unknown cause, affecting the skin and internal organs, characterized by fibrotic changes.Objective:To determine the correlation between serum homocysteine level and interstitial lung involvement in systemic sclerosis. </P><P> Materials and Methods: In this case – control study, 59 patients who fulfilled the ACR/EULAR classification criteria for systemic sclerosis and were referred to Hafez Hospital of Shiraz, Iran, were included as the case group. Fifty nine healthy subjects were involved as the control group. Patients were divided into two groups based on interstitial lung involvement and two subtypes, diffuse and limited type. Serum homocysteine, vitamin B12, and folate levels compared between the controls, and cases groups.Results:Of 59 case and control group, 53 (%89.8) were female and the mean age did not differ in both groups (P=0.929). Thirty five (%59.3) patients had interstitial lung involvement and 38(%64.4) had diffuse cutaneous systemic sclerosis. The mean serum homocysteine level was 13.9±6.3 µmol/L in the case and 13.7±9.2 µmol/L in the control group (P=0.86). The mean serum homocysteine level did not differ between the patients with and without interstitial lung involvement (P=0.52). The patients with lung involvement was older than those without lung involvement (P=0.004). Lung disease was more common in diffuse type (P=0.014).Conclusion:In our study, serum homocysteine level did not differ between the patients and healthy subjects. Also, there was no correlation between serum homocysteine level and lung involvement, but lung involvement was more common in older patients and also diffuse subtype.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thang Nguyen-Tien ◽  
Duy Cuong Do ◽  
Xuan Luat Le ◽  
Thi Hai Dinh ◽  
Mats Lindeborg ◽  
...  

Abstract Background Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries. Methods During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status. Results The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16–30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13–0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention. Conclusions All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.


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