Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

Huang, William; Gowda, Meghana; Donnelly, James G.

doi:10.1055/s-0028-1103158

Cited by 28 publications

(27 citation statements)

References 9 publications

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“…In agreement with Huang et al [15], we could not find that calculation of CA/CDCA ratio can provide additional information for better diagnosis of ICP. Mean values of DCA determinations showed no significant difference between healthy pregnants and ICP patients and they could not be taken as a useful indicator.…”

Section: Diagnosis and Prediction Of Icp Through Calculation Of Sesupporting

confidence: 90%

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In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

et al. 2012

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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.

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Section: Diagnosis and Prediction Of Icp Through Calculation Of Sesupporting

confidence: 90%

“…However, a latter report has recently determined that calculation of cholic acid/chenodeoxycholic acid (CA/CDCA) ratio contributes little to ICP diagnosis [15]. …”

Section: Introductionmentioning

confidence: 99%

In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

et al. 2012

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“…[33][34][35] The use of the bile acid ratio to diagnose ICP was recently evaluated, and it was found that the CA/CDCA ratio added little to the diagnosis of ICP and that the total bile acid concentration and transaminase levels were more useful. 36 …”

Section: Diagnosismentioning

confidence: 97%

Cholestasis of Pregnancy

Pathak

Sheibani

Lee

2010

Obstetrics and Gynecology Clinics of North America

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“…24 However, 1 study noted that total bile acid level was superior to the cholic acid:chenodeoxycholic acid ratio for the diagnosis of ICP. 25 Third, we did not specifically query women about pruritus during their interview. Thus, mild symptoms may not have been ascertained from the medical record.…”

Section: Commentmentioning

confidence: 99%

Bile acids in a multicenter, population-based case-control study of stillbirth

Silver

Parker

Goldenberg

et al. 2014

American Journal of Obstetrics and Gynecology

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OBJECTIVE We sought to compare bile acids in women with and without stillbirth in a population-based study. STUDY DESIGN The Stillbirth Collaborative Research Network conducted a multisite, population-based case-control study of stillbirth (fetal deaths ≥20 weeks). Maternal sera were obtained at the time of enrollment and frozen at −80° until assay for bile acids. RESULTS Assays were performed in 581 women with stillbirth and 1546 women with live births. Bile acid levels were slightly higher in women with stillbirth (geometric mean [95% confidence interval {CI}] = 3.2 [3.0–3.5]) compared to live births (2.9 [2.7–3.1], P = .0327). However, the difference was not significant after adjustment for baseline risk factors for stillbirth. The proportion of women with elevated levels (≥10 or ≥40 μmol/L) was similar in stillbirths and live births. Results were similar when the analysis was limited to subsets of stillbirths and live births. In women with stillbirths not associated with fetal anomalies or obstetric complications bile acid levels were higher than in women with term live births (geometric mean [95% CI] = 3.4 [3.0–3.8] vs 2.9 [2.7–3.0], P = .0152, unadjusted; P = .06, adjusted). However, a similar proportion of women in both groups had levels ≥10 mmol/L (10.7 vs 7.2%; odds ratio [OR], 1.54; 95% CI, 0.97–2.44; adjusted OR, 1.29; 95% CI, 0.78–2.15) and ≥40 μmol/L (1.7 vs 0.7%; OR, 2.58; 95% CI, 0.85–7.84; adjusted OR, 2.28; 95% CI, 0.79–6.56). CONCLUSION Our data do not support testing for bile acids in cases of stillbirth in the absence of clinical evidence of intrahepatic cholestasis of pregnancy.

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Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

Cited by 28 publications

References 9 publications

In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

Cholestasis of Pregnancy

Bile acids in a multicenter, population-based case-control study of stillbirth

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