scholarly journals Case Report: Intrahepatic Cholestasis of Pregnancy

2016 ◽  
Vol 06 (02) ◽  
pp. 063-065
Author(s):  
Precilla D'silva ◽  
Jasmine Maria Lobo ◽  
Akhila Mol Babu
Keyword(s):  
Case Report ◽  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Elevated Serum ◽  
Signs And Symptoms ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Third Trimester ◽  
Gradual Onset ◽  
Serum Aminotransferases ◽  
Cholestasis Of Pregnancy

AbstractIntrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by pruritus, elevated serum aminotransferases and bile acid levels with gradual onset in the second or third trimester of pregnancy, and spontaneous relief of signs and symptoms within two to three weeks after delivery.

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 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.

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 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 Obstetric Cholestasis: A Review and Update

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Olawumi Adaramodu ◽  
Anthony Kodzo-Grey Venyo
Keyword(s):  
Liver Function ◽  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Liver Function Tests ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Third Trimester ◽  
Serum Bile Acids ◽  
Function Tests ◽  
Cholestasis Of Pregnancy ◽  
In Pregnancy

Obstetric cholestasis (OC) is a liver disorder that occurs in the late second and early third trimester of pregnancy characterized by pruritus with increased serum bile acids and other liver function tests. The pathophysiology of OC is still not completely understood. The symptoms and biochemical abnormality rapidly resolve after delivery. OC is associated with an increased risk of adverse obstetrical outcomes. The aetiology of obstetric cholestasis of pregnancy is poorly understood and is thought to be complicated and multifactorial.  OC typically occurs in the late second trimester when the oestrogen levels are the highest in pregnancy. The most common complaint is generalized intense pruritus, which usually starts after the 30th week of pregnancy. Pruritus can be more common in the palms and soles and is typically worse at night. Other symptoms of cholestasis, such as nausea, anorexia, fatigue, right upper quadrant pain, dark urine, and pale stool, can be present. Clinical jaundice is rare but may present in 14% to 25% of patients after 1 to 4 weeks of the onset of pruritus. Some patients also complain of insomnia as a result of pruritus. Generally, physical examination is unremarkable except for scratch marks on the skin from pruritus. Pruritus is a cardinal symptom of intra-hepatic cholestasis of pregnancy (ICP) and may precede biochemical abnormalities. The diagnosis of intrahepatic cholestasis of pregnancy is via the presence of clinical symptoms pruritus in the third trimester with elevated maternal total serum bile acids and excluding other diagnoses, which can cause similar symptoms and lab abnormalities. Fasting blood samples should be used to check for the total bile salt acid level as it can become elevated in the postprandial state. Once the diagnosis of OC of pregnancy is confirmed, immediate treatment is necessary, and the primary goal of therapy is to decrease the risk of perinatal morbidity and mortality and to alleviate maternal symptoms. Maternal pruritus can be alleviated with use of moisturisers and oral antihistamines. Ursodeoxycholic acid (UDCA) is the drug of choice for the treatment of ICP. Many authors have advocated elective early delivery of women with intrahepatic cholestasis of pregnancy to reduce the risk of sudden foetal death. The Royal College of Obstetricians and Gynaecologists recommends induction of labour after 37+0 weeks of gestation. Obstetric cholestasis of pregnancy is not an indication for Caesarean delivery. Postpartum pruritus typically disappears in the first 2 to 3 days following delivery, and serum bile acid concentrations will normalize eventually. ICP is not a contraindication to breastfeeding, and mothers with a history of ICP in pregnancy can breastfeed their infants. Postpartum monitoring and follow up of bile acids and liver function tests should be done in 4-6 weeks to ensure resolution. Women with the persistent abnormality of liver function test after 6 to 8 weeks require investigation for other aetiologies.

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