Body mass index implications in intrahepatic cholestasis of pregnancy and placental histopathological alterations

Valdovinos-Bello, Violeta; García-Romero, Carmen Selene; Cervantes-Peredo, Alicia; García-Gómez, Elizabeth; Martínez-Ibarra, Alejandra; Vázquez-Martínez, Edgar Ricardo; Valdespino, Yolotzin; Cerbón, Marco

doi:10.1016/j.aohep.2022.100879

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…Of note, there is growing evidence suggesting the association of ICP with elevated risks for developing preeclampsia, gestational diabetes, and metabolic disorders ( Martineau et al, 2015 ; Shan et al, 2016 ; Menżyk et al, 2018 ; Valdovinos-Bello et al, 2023 ). The altered glucose and lipid metabolism of ICP patients could be partially contributed by the reduction in the activity of FXR and Takeda G protein-coupled receptor (TGR5).…”

Section: Discussionmentioning

confidence: 99%

“…The impairments of FXR and TGR5 were also involved in the dysregulated synthesis and metabolism of lipid profiles in ICP pregnancies ( de Aguiar Vallim et al, 2013 ; Chiang and Ferrell, 2020 ; Zhan et al, 2022 ). In ICP patients complicated with obesity, risks for development of PE, GDM and other hepatopathies were even further increased, suggesting a more severe dysregulation in the metabolic homeostasis ( Valdovinos-Bello et al, 2023 ). However, recent studies exploring the hepatoprotective treatments in ICP were focused on the therapeutic effect in hepatic biochemical indicators, the improvement in the comorbidities of ICP have not been investigated.…”

Section: Discussionmentioning

confidence: 99%

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Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects

Shan,

Dai,

Chen

et al. 2023

Front. Pharmacol.

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Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained distressing pruritus in the mother and poses significant risk to the fetus of perinatal mortality. Occurring in the second and third trimester, the serum bile acid and aminotransferase are usually elevated in ICP patients. Ursodeoxycholic acid (UDCA) is the first line drug for ICP but the effectiveness for hepatoprotection is to a certain extent. In ICP patients with severe liver damage, combination use of hepatoprotective agents with UDCA is not uncommon. Herein, we reviewed the current clinical evidence on application of hepatoprotective agents in ICP patients. The underlying physiological mechanisms and their therapeutic effect in clinical practice are summarized. The basic pharmacologic functions of these hepatoprotective medications include detoxification, anti-inflammation, antioxidation and hepatocyte membrane protection. These hepatoprotective agents have versatile therapeutic effects including anti-inflammation, antioxidative stress, elimination of free radicals, anti-steatohepatitis, anti-fibrosis and anti-cirrhosis. They are widely used in hepatitis, non-alcoholic fatty liver disease, drug induced liver injury and cholestasis. Evidence from limited clinical data in ICP patients demonstrate reliable effectiveness and safety of these medications. Currently there is still no consensus on the application of hepatoprotective agents in ICP pregnancies. Dynamic monitoring of liver biochemical parameters and fetal condition is still the key recommendation in the management of ICP pregnancies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects

Shan,

Dai,

Chen

et al. 2023

Front. Pharmacol.

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“…Proper follow ups were done in all pregnant women till the delivery having gestational age ≤ 41 weeks. All necessary data regarding feto-maternal outcomes according to operational definitions was documented on a proforma like mode of delivery, APGAR Score <7 on 5…”

Section: Methodsmentioning

confidence: 99%

“…ICP disturbs fetomaternal life and increases stress of the pregnancy by the risk of adverse outcomes, intense pruritus and disturbed sleep pattern. 5 At present fetomaternal care has been improved but still ICP causes negative fetal outcomes like premature birth, meconium stained amniotic fluid, bradycardia of the fetus, fetal respiratory distress and ultimately leading to intrauterine death of the fetus. 6 ICP is associated with increased maternal and fetal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Fetomaternal Complications Due to Intrahepatic Cholestasis of Pregnancy

Rehman,

Gulbaz,

Zafar

et al. 2023

PJMHS

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Objective: To study frequency of complications in fetus and mothers developed due to intrahepatic cholestasis during pregnancy. Materials and methods: This is a cross sectional study conducted in the department of gynecology and obstetrics Rai medical College Sargodha. Study was commenced in July 2022 and completed in December 2022. Study sample was calculated using WHO sample size calculator. Pregnant ladies presenting with intrahepatic cholestasis of pregnancy having age 16-40 years were included in this study. Patients with multiple pregnancies, or having carcinoma of liver, presence of chronic liver disease or history of alcohol addiction were excluded from the study. Proper follow ups were done in all pregnant women till the delivery having gestational age ≤ 41 weeks. All necessary data regarding feto-maternal outcomes was documented on a proforma like mode of delivery, APGAR Score, postpartum hemorrhage, low birth weight, meconium stained liquor, premature birth or intrauterine fetal death. Results: This study was conducted on 130 cases with intrahepatic cholestasis, cesarean section was done in 55(42.3%) cases, post-partum hemorrhage reported in 09(6.9%), APGAR score was <7 at five minutes in 11(8.5%), preterm birth happened in 29(22.3%), low birth weight reported in 12(9.2%), intrauterine death of the fetus reported in 08(6.1%) and meconium stained liquor was noted in 41(31.5%) cases. Mean age of the mothers was 24±3.7 years. Practical Implication: In our community we have to consider this health issue seriously if we want to reduce mortality due to ICP and its associated complications in our community. Conclusion: This study concluded that intrahepatic cholestasis of pregnancy is related to poor fetomaternal outcomes that can be prevented by some serious recommendations for such high risk pregnancies. It will reduce fetomaternal morbidity and mortality rate in our setups. Keywords: Intrahepatic cholestasis, Intrauterine death, Pregnancy, Fetomaternal complications, Postpartum hemorrhage,

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SWATH proteomics analysis of placental tissue with intrahepatic cholestasis of pregnancy

Jiang¹,

Yin²,

Xu³

et al. 2023

Placenta

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Body mass index implications in intrahepatic cholestasis of pregnancy and placental histopathological alterations

Cited by 7 publications

References 24 publications

Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects

Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects

Frequency of Fetomaternal Complications Due to Intrahepatic Cholestasis of Pregnancy

SWATH proteomics analysis of placental tissue with intrahepatic cholestasis of pregnancy

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