scholarly journals In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Manuela Martinefski ◽  
Mario Contin ◽  
Silvia Lucangioli ◽  
Maria Beatriz Di Carlo ◽  
Valeria Tripodi
Keyword(s):  
Pregnant Women ◽  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Biochemical Parameter ◽  
Total Serum ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Predictive Values ◽  
Benign Condition ◽  
Cholestasis Of Pregnancy

Until now, biochemical parameter for diagnosis of intrahepatic cholestasis of pregnancy (ICP) mostly used is the rise of total serum bile acids (TSBA) above the upper normal limit of 11 μM. However, differential diagnosis is very difficult since overlapped values calculated on bile acids determinations, are observed in different conditions of pregnancy including the benign condition of pruritus gravidarum. The aim of this work was to determine the better markers in ICP for a precise diagnosis together with parameters associated with severity of symptoms and treatment evaluation. Serum bile acid profiles were evaluated using capillary electrophoresis in 38 healthy pregnant women and 32 ICP patients and it was calculated the sensitivity, specificity, accuracy, predictive values and the relationships of certain individual bile acids in pregnant women in order to replace TSBA determinations. The evaluation of the results shows that LCA and UDCA/LCA ratio provided information for a more complete and accurate diagnosis and evaluation of ICP than calculation of solely TSBA levels in pregnant women.

scholarly journals Intrahepatic Cholestasis of Pregnancy: A Case Study of the Rare Onset in the First Trimester

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 454 ◽  
Author(s):  
Milos Stulic ◽  
Djordje Culafic ◽  
Ivan Boricic ◽  
Milica Stojkovic Lalosevic ◽  
Nina Pejic ◽  
...  
Keyword(s):  
Bile Acids ◽  
Reference Values ◽  
Intrahepatic Cholestasis ◽  
First Trimester ◽  
Liver Disorder ◽  
Total Serum ◽  
Serum Bile Acid ◽  
Close Monitoring ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Cholestasis Of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a gestation-specific liver disorder, defined most often as the onset of pruritus, usually from the third trimester of pregnancy, associated with abnormal liver test results and/or increased total serum bile acids and spontaneous relief after delivery. The 21-year-old patient was admitted to our ward in the 11th week of pregnancy due to raised liver enzymes. The first onset of pruritus and jaundice appeared a month before hospitalization. Immunology tests and Toxoplasma gondii were negative. We excluded viral etiology, while alpha-1-antitrypsin, serum and urine copper levels, and thyroid hormones were within the reference values. The patient denied she had taken any medicines and herbal preparations before and during pregnancy. Total bile acids in the serum were significantly elevated (242 μmol/L). The abdominal ultrasound revealed a regular finding. Liver biopsy suggested a cholestatic liver disorder. After a presentation of all risks, the patient decided to stop the pregnancy. After a month, the hepatogram was within the reference values. Very rarely an ICP can occur in early pregnancy (first trimester), which calls for close monitoring. The risk of serious adverse fetal outcomes and spontaneous preterm delivery is proportional with increased levels of maternal serum bile acid.

scholarly journals Benign Recurrent Intrahepatic Cholestasis in Pregnancy: Fetal Death at 36 Weeks of Gestation

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Mariam Ayyash ◽  
Nicolina Smith ◽  
Madhurima Keerthy ◽  
Ashina Singh ◽  
Majid Shaman
Keyword(s):  
Bile Acid ◽  
Intrahepatic Cholestasis ◽  
Liver Toxicity ◽  
Total Serum ◽  
Serum Bile Acid ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Benign Recurrent Intrahepatic Cholestasis ◽  
Individualized Approach ◽  
Cholestasis Of Pregnancy ◽  
In Pregnancy

Introduction. Benign recurrent intrahepatic cholestasis is a rare hepatologic disorder characterized by recurrent, self-limited episodes of severe pruritus, jaundice, and elevated bile acids. While there are guidelines for the management of intrahepatic cholestasis of pregnancy, the literature regarding benign recurrent intrahepatic cholestasis and pregnancy is limited. Case. A 29-year-old G1P0 woman, with history of liver toxicity, had elevated total serum bile acid levels and liver enzymes documented at 8 weeks of gestation and throughout her pregnancy. She had a reactive nonstress test just 3 days prior to her induction. Fetal demise was noted when she presented at 36 weeks for her induction. Conclusion. We recommend that women with elevated total serum bile acid early in pregnancy due to a separate entity relative to intrahepatic cholestasis of pregnancy be managed in a more individualized approach.

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