Intrahepatic Cholestasis of Pregnancy

Jurk, Stanisław M.; Kremer, Andreas E.; Schleußner, E

doi:10.1055/a-1522-5178

Cited by 9 publications

(6 citation statements)

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“…Our study also found that twin pregnancies and IVF were associated with a higher risk of ICP, which is consistent with previously reported findings [ 26 , 27 , 39 ]. The association of ICP with twin pregnancies and IVF may be related to the increased levels of hormones in this population, which triggers the accumulation of progesterone metabolites, resulting in disordered hepatocyte bile acid secretion and cholestasis [ 4 , 14 , 26 , 40 ]. Moreover, studies have reported that a higher level of oestrogen in twin pregnancies is correlated with an increased risk of ICP [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, ICP may cause preterm birth, foetal asphyxia, meconium-stained amniotic fluid, cardiotocography abnormalities, a low (<7) 5-min Apgar score, respiratory distress syndrome, and even intrauterine foetal death [ 5 , 10–13 ]. The pathogenesis of ICP is multifactorial and remains unclear although hormonal, genetic, and environmental factors have been implicated [ 4 , 14–16 ]. Previous studies have shown that multiple pregnancies, in vitro fertilization (IVF), maternal age >35 years, women with a history of liver-related diseases, particularly gallstone and chronic hepatitis C infection, as well as a previous history of ICP increase the risk [ 8 , 17–21 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, risk factors and adverse perinatal outcomes for Chinese women with intrahepatic cholestasis of pregnancy: a large cross-sectional retrospective study

Yin

et al. 2022

Annals of Medicine

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Background Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder and may cause adverse perinatal outcomes. This large cross-sectional retrospective study aimed to evaluate the prevalence and related risk factors of ICP and determine the adverse perinatal outcomes. Methods This large cohort study from 1 January 2018 to 31 December 2019, included 39,742 eligible pregnant women. Data were extracted from the institutional electronic medical record database and analyzed using univariate and multivariate logistic regression models to determine the risk factors and adverse perinatal outcomes of ICP. Results The overall prevalence of ICP was 3.81%. It was significantly higher in hepatitis B surface antigen (HBsAg) positive than negative women in all age groups, and in women with pre-pregnancy BMI underweight and obesity aged <25 years and ≥35 years than the other age groups. Multivariate logistic regression models showed an increased risk of ICP associated with maternal age <25 years and ≥35 years, pre-pregnancy underweight and obesity, HBsAg positive status, twin pregnancies, low maternal education, inadequate gestational weight gain, multiparous, in vitro fertilization, caesarean section history and the number of abortions ≥2. The presence of ICP was associated with increased risk of maternal outcomes of caesarean section and preterm birth, and neonatal outcomes of low birth weight and neonatal unit admission in singleton and twin pregnancies. Conclusion This study identified the prevalence, possible risk factors, and associated adverse perinatal outcomes of ICP, which provides useful information for clinicians to identify, counsel, and provide timely management for women at risk. KEY MESSAGES Maternal age <25 and ≥35, pre-pregnancy BMI underweight and obesity, hepatitis B surface antigen-positive status, twin pregnancies, low maternal education, inadequate gestational weight gain, multiparous, in vitro fertilization, caesarean section history and the number of abortions ≥2 are associated with an increased risk of ICP. Further, pregnancies with ICP are associated with an increased risk of maternal outcomes of caesarean section and preterm birth and neonatal outcomes of low birth weight and neonatal unit admission in singleton and twin pregnancies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence, risk factors and adverse perinatal outcomes for Chinese women with intrahepatic cholestasis of pregnancy: a large cross-sectional retrospective study

Yin

et al. 2022

Annals of Medicine

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“…biliares dependientes de sodio y del receptor 4 del factor de crecimiento de fibroblastos de membrana (19,20). También existe la posibilidad de utilizar s-adenosilmetionina junto con UDCA en el tratamiento de la CIE, mediante una acción sinérgica para reducir las concentraciones de ácidos biliares (23,24).…”

Section: Complicaciones Maternas Y Perinatalesunclassified

“…Este es administrado por vía oral a dosis de 10-16 mg/Kg/ día, dos o tres veces al día, alcanzando una dosis de 250-300 mg (17,18). La administración de UDCA en embarazadas con CIE y tiempo de protrombina prolongado puede disminuirse en dosis de 10 mg/Kg/ día para minimizar el riesgo de hemorragia posparto, asociada a deficiencia de vitamina K (factores II, VII, IX y X) (19).…”

Section: Manejounclassified

Diagnóstico y manejo de la colestasis intrahepática en el embarazo

Briceño-Sanabria¹,

Briceño-Pérez²

2023

RSOGV

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Intrahepatic cholestasis of pregnancy is caused by a dysfunction of the hepatocytes, typical of pregnancy. High concentrations of sex hormones and genetic predisposition appear to be important factors for their development. The incidence depends on the ethnic composition of the population and the diagnostic criteria used. It is characterized by increasing and persistent pruritus, increased concentrations of bile acids, usually in the late second or third trimester of pregnancy. It leads to the occurrence of uteroplacental hypoxia that increases the risk of meconium amniotic fluid, preterm delivery, preeclampsia, postpartum hemorrhage, neonatal respiratory distress syndrome, and perinatal death. Therapeutic management is aimed at reducing clinical symptoms, normalizing maternal biochemical changes, and preventing fetal complications. The main pharmacological treatment consists of the administration of ursodeoxycholic acid. The objective of this research is to evaluate the diagnosis and management of intrahepatic cholestasis of pregnancy

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“…The general incidence of IHCP depending on the geographic variation varies from 1.0-27.6%. 5,6 It shows differences based on environmental factors and ethnic groups. , Incidence is 1.24% in the Indian population, while it is 1.46% in the Pakistani population, the white population has a low incidence of 0.62%.…”

Section: Introductionmentioning

confidence: 99%

Obstetric cholestasis and its impact on the maternal outcome

TIWARI,

PARVEEN,

NOOR

2024

Preprint

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AIM To evaluate the association of GDM and pre-eclampsia in women with obstetric cholestasis MATERIAL AND METHODS Pregnant women with >28weeks gestation attending ANC, OPD and labour room of J.N.M.C.H,AMU, Aligarh U.P (India) from 2020-2022 were included in the study after taking informed consent and ethical approval from the Institute. Women were divided into two groups ie group 1 having 200 women with IHCP and group 2 having 200 healthy pregnant women, both the groups were followed up for the development of GDM and pre-eclampsia. RESULTS A statistically significant association was observed between IHCP and development of GDM (26.5% & Odds ratio 1.64) and pre-eclampsia (17% & Odds ratio 1.95) (p<0.05), also GDM and pre-eclampsia were found to be significantly associated with the severity of cholestasis (p<0.05). Thus on calculating odds ratio, we found higher odds of developing GDM and Pre-eclampsia in IHCP group with raised serum bile acid levels, maximum at 60μmol/L level as compared to 10-40 μmol/L (GDM: OR:8.647 & Pre-eclampsia: OR:6.303). Induction and cesarean rate was significantly higher in IHCP group (p<0.05). CONCLUSION Our study concludes significant association of IHCP with GDM and Pre- eclampsia as all three shares common pathogenetic pathways and greater risk of development was at higher serum bile acid levels.

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Intrahepatic Cholestasis of Pregnancy

Cited by 9 publications

References 71 publications

Prevalence, risk factors and adverse perinatal outcomes for Chinese women with intrahepatic cholestasis of pregnancy: a large cross-sectional retrospective study

Prevalence, risk factors and adverse perinatal outcomes for Chinese women with intrahepatic cholestasis of pregnancy: a large cross-sectional retrospective study

Diagnóstico y manejo de la colestasis intrahepática en el embarazo

Obstetric cholestasis and its impact on the maternal outcome

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