Evaluation of predictive value of biochemical markers for adverse obstetrics outcomes in pregnancies complicated by cholestasis

Guszczynska-Losy, Milena; Wirstlein, Przemysław; Wender-Ożegowska, Ewa; Kędzia, Małgorzata

doi:10.5603/gp.2020.0051

Cited by 14 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The meta-analysis by Ovadia et al of fasting pregnant women with ICP (n = 1726) showed a median level of 23.0 µmol/L (IQR 14.7 – 41) versus 32.0 µmol/L (IQR 19.0 – 61.5) in postprandial patients (n = 2795) 68 . Irrespective of fasting and UDCA therapy, various analyses have shown the elevated total serum bile acid level to be a sensitive and specific marker (OR = 4.17, p = 0.0037, AUC = 0.62, p = 0.046) in the diagnosis of ICP and the related adverse perinatal outcome 107 , 108 .…”

Section: Diagnosismentioning

confidence: 99%

“…In der Metaanalyse von Ovadia et al zeigte sich unter nüchtern gemessenen Schwangeren mit ICP (n = 1726) ein Median von 23,0 µmol/l (IQR 14,7 – 41) gegenüber postprandialen Patientinnen (n = 2795) von 32,0 µmol/l (IQR 19,0 – 61,5) 68 . Unberücksichtigt der Nüchternheit und einer UDCA-Therapie ist die Erhöhung der Gesamt-Gallensäuren im Serum in verschiedenen Analysen ein sensitiver und spezifischer Marker (OR = 4,17, p = 0,0037, AUC = 0,62, p = 0,046) für die Diagnose einer ICP und des damit verbundenen ungünstigen perinatalen Outcomes 107 , 108 .…”

Section: Gallensäurenunclassified

See 1 more Smart Citation

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Hagenbeck

Hamza

Kehl

et al. 2021

Geburtshilfe Frauenheilkd.

View full text Add to dashboard Cite

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease specific to pregnancy. The cardinal symptom of pruritus and a concomitant elevated level of bile acids in the serum and/or alanine aminotransferase (ALT) are suggestive for the diagnosis. Overall, the maternal prognosis is good. The fetal outcome depends on the bile acid level. ICP is associated with increased risks for adverse perinatal outcomes, including preterm delivery, meconium-stained amniotic fluid, and stillbirth. Acute fetal asphyxia and not chronic uteroplacental dysfunction leads to stillbirth. Therefore, predictive fetal monitoring is not possible. While medication with ursodeoxycholic acid (UDCA) improves pruritus, it has not been shown to affect fetal outcome. The indication for induction of labour depends on bile acid levels and gestational age. There is a high risk of recurrence in subsequent pregnancies.

show abstract

Section: Diagnosismentioning

confidence: 99%

Section: Gallensäurenunclassified

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Hagenbeck

Hamza

Kehl

et al. 2021

Geburtshilfe Frauenheilkd.

View full text Add to dashboard Cite

show abstract

“…Evaluating the possible roles of molecules mentioned above, in the physiological and pathophysiological states of pregnancy, authors thought that measurements of serum leptin, adiponectin, apelin, and ghrelin in pregnant women with ICP may provide meaningful supports for their diagnostic roles in the management of ICP. Previous studies have shown that serum levels of total bile acid, aspartate transaminase, and alanine transaminase, and serum activities of alcohol dehydrogenase and aldehyde dehydrogenase are higher in women with ICP than in women without ICP, except those with other hepatobiliary diseases [ 34 , 35 ]. Although these indicators contain diagnostic values, they can also increase after some liver diseases, preeclampsia, chronic inflammatory diseases, and infections.…”

Section: Introductionmentioning

confidence: 99%

Predictive and Diagnostic Value of Serum Adipokines in Pregnant Women with Intrahepatic Cholestasis

Yurtçu

Çalışkan

Güvey³

et al. 2022

IJERPH

View full text Add to dashboard Cite

The objective of this study was to assess the value of serum leptin, adiponectin, apelin, and ghrelin as biomarkers for the prediction and diagnosis of intra-hepatic cholestasis (ICP). This prospective study included pregnant women in the third trimester of pregnancy: 63 with ICP, 48 and 15 of whom had mild and severe disease, respectively, and 32 as controls. ICP women had increased median levels of serum leptin, adiponectin, apelin, and ghrelin compared to the controls (p < 0.05). These biomarkers meaningfully changed regarding the severity of ICP: While leptin was reduced, apelin and ghrelin were increased, and adiponectin was increased somewhat. To predict and diagnose ICP, the predictive values of serum leptin, adiponectin, and apelin need to be accepted as comparable, with moderate to high sensitivity and specificity; however, the predictive value of serum ghrelin was somewhat lower. More research is needed to clarify the potential properties of adipokines to gain acceptance as a predictive or diagnostic biomarker for ICP.

show abstract

“…Intrahepatic cholestasis of pregnancy (ICP) is a particular complication during the second and third trimester of pregnancy, which is mainly characterized by skin itching, abnormal liver function, and elevated serum total bile acid level (TBA). The pathogenesis of ICP is still unclear 1,2 . ICP mainly affects the growth and development of the fetus, including premature birth, fetal distress, neonatal asphyxia, and even neonatal death 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Study on plasma exosome biomarkers of pregnant women with intrahepatic cholestasis of pregnancy

Feng

Jiang

Liu

et al. 2022

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

Background Elevated serum total bile acid level is currently the main index for clinical diagnosis of intrahepatic cholestasis of pregnancy, but the use of TBA as a detection index has certain limitations. The early diagnosis of ICP and new treatment options still need to be further strengthened.Methods: Plasma samples were collected, and exosomes were isolated. Key differential proteins were screened by bioinformatics methods. ELISA method was used to detect the concentration of the key differential protein cluster in plasma samples, and the ROC curve was drawn to nd out the best critical value.Results: There were 138 differentially expressed proteins between the ICP group and the normal group by quantitative analysis. Cluster protein was screened as a clinical validation index. The cluster protein concentration of plasma exosomes in the ICP group was signi cantly higher than that in the normal group (P<0.0001). ROC curve analysis showed that the best critical point for diagnosing ICP according to the plasma exosome cluster protein concentration of pregnant women was 255.28 ng/ml. In the ICP group, the best crucial point for predicting ICP with premature delivery is 286.72 ng/ml. Conclusion: the plasma exosome cluster protein concentration of ICP pregnant women is signi cantly higher than that of normal pregnant women. When the plasma cluster protein concentration of pregnant women is more remarkable than 255.28ng/ml, ICP can be diagnosed. When the plasma cluster protein concentration of pregnant women is higher than 286.72ng/ml, ICP pregnant women are more likely to have a premature birth.

show abstract

Evaluation of predictive value of biochemical markers for adverse obstetrics outcomes in pregnancies complicated by cholestasis

Cited by 14 publications

References 0 publications

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Predictive and Diagnostic Value of Serum Adipokines in Pregnant Women with Intrahepatic Cholestasis

Study on plasma exosome biomarkers of pregnant women with intrahepatic cholestasis of pregnancy

Contact Info

Product

Resources

About