Cholestasis of pregnancy: in need of a more rapid diagnosis

Caughey, Aaron B.

doi:10.1038/sj.jp.7211565

J Perinatol

2006

DOI: 10.1038/sj.jp.7211565

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Cholestasis of pregnancy: in need of a more rapid diagnosis

Aaron B. Caughey

Abstract: bile acid levels. Placing the medical-legal aspects aside, optimizing patient care for women at risk of cholestasis of pregnancy depends on making a more rapid diagnosis. AB Caughey

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“…However, the test often takes 1 to 2 weeks, creating a delay in diagnosis. 4 In addition, the test is relatively expensive. Alternatives to liquid chromatography-tandem mass spectroscopy using enzymatic bile acid assays on standard chemistry autoanalyzers are available.…”

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confidence: 99%

Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

2008

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We sought to determine if the bile acid ratio of cholic acid to chenodeoxycholic acid (CA:CDCA) is an important component for diagnosis of intrahepatic cholestasis of pregnancy (ICP). We assessed the addition of bile acid CA:CDCA ratio information in diagnosing ICP in a database of patients evaluated for ICP by serum bile acids and hepatic transaminases. Patients were considered to test positive for ICP if there was elevation in total bile acid, CA:CDCA ratio, or transaminase. Of 231 specimens evaluated for ICP with bile acid and transaminases, 17.1% had elevated total bile acids, 29.4% had elevated transaminase, and 8.2% had an elevated bile acid ratio. Most specimens with elevated bile acid ratio also had elevated total bile acid; 35.5% of specimens tested positive by total bile acid and/or transaminases, increasing minimally to 35.9% with bile acid ratio information. Similar results were found using lower total bile acid and bile acid ratio thresholds. The bile acid CA:CDCA ratio contributed little to the diagnosis of ICP. The use of total bile acid and hepatic transaminases without bile acid ratios decreased positive tests by less than 2%.

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Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

2008

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Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays

Huang¹,

Seubert²,

Donnelly³

et al. 2007

Journal of Perinatal Medicine

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Perinatal Outcome in Pregnancy Complicated by Obstetric Cholestasis at Obstetrics and Gynaecology Department of Skmch, Muzaffarpur, Bihar

Kumari

Bibha

Sinha

et al. 2021

ijsr

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Aim:To determine the perinatal outcome in pregnancy complicated by obstetric cholestasis. Study type, Setting, duration: This descriptive study was conducted in Obstetrics and Gynaecology Department of SKMCH, Muzaffarpur, Bihar from September 2019 to August 2020. Methods: All the pregnant ladies who were diagnosed as having obstetric cholestasis and delivered during the study period were included in the study. Variables studied included age, parity, gestational age of appearance of symptoms, sign /symptoms, liver function tests, mode of delivery and fetal outcome. Information was collected on a predesigned questionnaire. SPSS version 15 was used for analysis. Results: Total 1250 patients were delivered in this hospital during the study period. Out of these 35 cases [2.8%] were diagnosed to have obstetric cholestasis. The mean age of subjects was 26.4 years. The data of parity showed 15(42.8%) were primigravida and 20(57.1%) were multi gravida. The most common presenting symptom was pruritis (91.4%).Gestational age at which symptoms appeared first was 34-36 weeks in 22 patients (65.8%),32-34 weeks in 5 cases (14.4%),before 32 weeks in 4 cases (11.4%)and 37 week in 3 cases(8.6%).Out of 35 cases 15 patients (42.8%) had normal vaginal delivery and 20 patients (57.2%)were delivered by cesarean section. Perinatal outcome revealed 10 babies (28.5%)were meconium stained,6 babies(17.1%) showed abnormal CTG pattern. Intrauterine growth retardation was seen in 6(17.1%) and prematurity in 9 cases(25.8%).Intrauterine death occurred in 1 patient(2.8%). Conclusion: Cholestasis of pregnancy has adverse effects on perinatal outcome, hence early diagnoses, vigilant follow up and timely delivery is essential.

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Cholestasis of pregnancy: in need of a more rapid diagnosis

Abstract: bile acid levels. Placing the medical-legal aspects aside, optimizing patient care for women at risk of cholestasis of pregnancy depends on making a more rapid diagnosis. AB Caughey

Cited by 3 publications

References 13 publications

Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

Bile Acid Ratio in Diagnosis of Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays

Perinatal Outcome in Pregnancy Complicated by Obstetric Cholestasis at Obstetrics and Gynaecology Department of Skmch, Muzaffarpur, Bihar

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