Abstract
Objective:Intrahepatic cholestasis of pregnancy (ICP) complicates pregnancies which is characterized by elevated serum bile acid levels. ICP increases maternal and fetal morbidities. This study was designed to determine the association of maternal and fetal complications and serum bile acid levels.Material and method:Maternal and fetal characteristics were analyzed from the medical records of 61 patients who gave birth following a pregnancy complicated with ICP between 2009 and 2013.Results:Eighty seven percent of 61 cases were singletons, and 13% of them were twins. Mean SBA level was 36 μmol/L. Preterm birth rate among singletons and twin pregnancies were 24.5% and 62.5%, respectively. Mean SBA level in preterm birth group was statistically higher with respect to the term birth group (100.8 μmol/L and 25.61 μmol/L, respectively; p=0.001). No perinatal mortality associated with ICP was detected in the study group.Conclusion:Pregnant women with the ICP compose high-risk group in regard to fetal and maternal risks. Close follow-up of these patients is required due to increased risks such as preterm delivery, meconium staining and fetal death.
Highlights
Intrahepatic cholestasis of pregnancy (ICH) is a disease of pregnants characterized with severe pruritus and increased levels of serum bile acids (SBA), seen in second and third trimesters
Sixty-two patients were diagnosed as Intrahepatic cholestasis of pregnancy (ICP) at study period
SBA values in patients with preterm delivery were found to be higher, which was statistically significant, when compared to the patients who delivered at term
Summary
Intrahepatic cholestasis of pregnancy (ICH) is a disease of pregnants characterized with severe pruritus and increased levels of serum bile acids (SBA), seen in second and third trimesters. The prevelance of ICH is significantly increased in twin pregnancies[5]. Since there are studies trying to explain etiologic factors (such as hormonal, genetic and inflamatory) causing the increased levels of maternal SBA levels, the etiology is not clear yet. There is increased level of liver enzymes but diagnosis should be based on elevated levels of SBA. Other laboratory findings of cholestasis accompany this increased level of bile acids. The differential diagnosis of viral hepatitis should be made in patients with severly-increased levels of aminotransferases[6]. The diagnosis of ICH should be based on laboratory findings of liver dysfunction in patients with severe pruritus[7].
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