İzole ve Komplike Kolestazlı Gebe Kadınların Perinatal Sonuçlarının Karşılaştırılması

Abstract

Abstract Introduction: Intrahepatic cholestasis in pregnancy encounters the risks of increased development retardation, preeclampsia and gestational diabetes. The aim of our study is to compare the perinatal outcomes in women diagnosed with isolated cholestasis or with cholestasis complicated with accompanying diseases. Material and Method: In our studies performed in a tertiary center, women applying to the antenatal clinic and diagnosed with cholestasis within a period of 2 years. Women with additional diseases were included in group 1, and those with isolated cholestasis were included in group 2. Maternal characteristics, laboratory results and perinatal outcomes were compared between these two groups. Findings: Cholestasis was found in 117 pregnant women in the 25101 births given within the study period (0,46%). Of these, cholestasis picture was found mild in 57 (48,8%), medium level in 38 (32,4%) and serious in 22 (18,8%). ICP (intrahepatic cholestasis of pregnancy) was found as isolated in 79 of these women (59%), of the remaining women, 38 had comorbidities (32,4%), 10 ha gestational diabetes (8,5%), 11 had preeclampsia (13,6%), and 21 had intrauterine growth retardation (17,9%). Meconium-stained amniotic fluid and premature labor rate were higher in pregnant women with determined cholestasis, and therefore, birth weeks and birth rate were lower. In the follow-up, the rates of the highest liver enzymes and fasting bile acid values, lower birth weeks, meconium-stained amniotic fluid and admission of the neonatal in the neonatal intensive care unit were found higher in pregnant women with complicated cholestasis as compared to the pregnant women with isolated cholestasis. Conclusion: Perinatal mortality and morbidity were found higher in pregnant women with cholestasis complicated with accompanying additional diseases. Therefore, closer follow-up and early termination of pregnancy can be proper in this complicated subgroup.