Maternal and Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis

Senocak, Gamze Nur Cimilli; Yılmaz, Emsal Pınar Topdağı

doi:10.5152/eurasianjmed.2019.18447

Cited by 11 publications

(5 citation statements)

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“…8 Additionally, 26.3% of women with a previous similar history of OC encountered the same risk in the present pregnancy, however, Senocak et al reports 6% of women had previous history the finding is not similar to our study the reason could be due to different settings, sample size, ethnicity. 12 …”

Section: Discussionmentioning

confidence: 99%

“… 2 , 10 Similarly, 82.5% of women delivered at term 37-42 weeks of gestation with a mean of 35.51 ±3.27 weeks and the median gestational weeks was 37 similar to the finding done in another teaching hospital in Nepal. 12 …”

Section: Discussionmentioning

confidence: 99%

“…Whereas an indication of emergency LSCS in the majority 18.8% of patients was non-reassuring nonstress test (NST) 6.3% due to failed induction, 6.3% due to fetal distress and 6.3% due to meconium-stained liquor, this finding was similar to finding with various studies. 10 , 12 Failed induction of labor in 33.33%, fetal distress 40%, non-progress of labor 26.66%. 10 …”

Section: Discussionmentioning

confidence: 99%

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Obstetric Cholestasis among Pregnant Women Visiting a Tertiary Care Centre

Yadav,

Pradhan

et al. 2023

J Nepal Med Assoc

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Introduction: Obstetric cholestasis is one of the most frequent hepatic disorders specific to pregnancy. It occurs commonly during the latter half of pregnancy. The data regarding this issue is rare in our settings. The aim of this study was to find out the prevalence of obstetric cholestasis among pregnant women visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among pregnant women, who attended a tertiary care centre from 24 July 2022 to 24 January 2023. Ethical approval was taken from the Institutional Review Committee of the same institute. Convenience sampling method was used. The point estimate was calculated at a 99% Confidence Interval. Results: The prevalence of obstetric cholestasis was 80 (1.38%) (1-1.80, 99% Confidence Interval). A total of 40 (50%) were in the age group 21-30 years, with a mean age of 28.06±6.39 years. A total of 48 (60%) were multigravida and 73 (91.30%) had singleton pregnancies. Pruritus of the whole body was complained of by 56 (70%) patients. Previous history of obstetric cholestasis was present in 21 (26.30%). Conclusions: The prevalence of obstetric cholestasis among pregnant women is lower than other studies done in similar settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Obstetric Cholestasis among Pregnant Women Visiting a Tertiary Care Centre

Yadav,

Pradhan

et al. 2023

J Nepal Med Assoc

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“…Prevalensi myoma uteri 40-60% terjadi pada perempuan usia produktif. Dikatakan bahwa ngka kejadian kehamilan dengan myoma sebanyak 1.2 -10.7 % (Cimilli Senocak & Topdagi Yilmaz, 2019;Winkjosastro, Saifuddin, & Rachimhadi, 2014). Pada umumnya myoma uteri bersifat asimptomatik dan ditemukan secara tidak sengaja pada saat pemeriksaan USG kehamilan (Egbe, Badjang, Tchounzou, Egbe, & Ngowe, 2018).…”

Section: Pendahuluanunclassified

Management Multiple Uterine Myoma in Pregnancy: A Case Report

Dwistayani

wijaya

2022

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Uterine myoma is a benign tumor originating from the smooth muscle of the uterus. In general, uterine myomas are asymptomatic and are found incidentally during ultrasound examination of pregnancy. We report that a 39-year-old woman with GIIP1001 admitted that she was 40 weeks pregnant and came with complaints of intermittent abdominal pain that started at 04.00 in the morning, getting worse 2 hours before MRS. Complaints accompanied by the discharge of blood mucus through the vagina. The patient was married 2 times and the distance between the first child and the second is 19 years. The patient's vital signs were within normal limits. On physical examination, there was a palpable mass with a smooth surface that seemed to stick to the uterus. Obstetrical examination revealed: uterine fundal height: 32cm, HIS + adequate, fetal heart rate 140 beats/minute, performance; head position. When a vaginal touch was performed, it was found that there was an opening of 1 cm with 25% thinning, the membranes were still intact. The patient was diagnosed with GIIP1001 UK 40-41 weeks+ Single live intra uterine + Primary old secondary + uterine myoma. The patient underwent cesarean section, the outcome of the baby and mother was good. Intraoperative findings found that there were 2 uterine myomas measuring more than 5 cm located in the subserosa and intramural so that the patient underwent a supravaginal hysterectomy. The age of the patient above 35 years is one of the considerations for tubectomy.

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“…Main features and diagnostic criteria are pruritus associated with elevated serum bile acid levels (above 10 µmol/L fasting, and 15 µmol/L non-fasting value) and/or disturbed liver function tests (LFT) [ 3 ]. Yet, ICP is diagnosed by exclusion and confirmed by the postpartal regression of symptoms and laboratory parameters [ 4 ]. Although not expected to cause serious maternal complications, it is associated with adverse perinatal outcomes, including spontaneous preterm birth (30–40%), meconium stained amniotic fluid (16–58%), neonatal respiratory distress syndrome (29%), and, most critically, sudden fetal death with the highest risk of occurrence after 37 weeks of gestation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic cholestasis of pregnancy: an evaluation of obstetric management in German maternity units

Zehner

Mai

Dückelmann

et al. 2022

Arch Gynecol Obstet

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Purpose Intrahepatic cholestasis of pregnancy (ICP) is associated with adverse fetal and neonatal outcome. Evidence for improvement by obstetric management is sparse. Common international guidelines recommend induction of labor before term, however, they differ in recommendations of monitoring the disease and time point of active management. So far, an official guideline for treatment and management of ICP in Germany does not exist. This study aims to compile common practice and policy in obstetric management of ICP in German maternity units. The objective is to gather obstetricians’ opinion on management of ICP, and to estimate the need for standardization of current practice in Germany on the background of existing evidence. Methods A questionnaire focusing on indications for interventions was developed including fourteen multiple-choice questions comprising the areas of diagnostic criteria, laboratory testing, fetal monitoring, treatment, and delivery timing. The survey was sent to 699 maternity clinics and was distributed to participants of the annual congress hosted by the German society of perinatal medicine (DGPM). Collected data were summarized and evaluated in relation to available evidence and existing guidelines. Descriptive statistics and Fisher's exact test were used. Results 334 completed questionnaires returned corresponding to a response rate of 48.1%. Coinciding with existing international guidelines, 48.8% of the participants acknowledge bile acid concentrations above 10 µmol/L to be indicative of ICP. 85.0% of obstetricians recommend antenatal testing with cardiotocography, exceeding common standards of maternity policy guidelines; 50.3% execute active management in ICP-affected pregnancies as they generally recommend a delivery between 37 + 0 and 38 + 6 weeks of gestation. Although recent studies evinced a risk of stillbirth in ICP-affected pregnancies not until a bile acid concentration of > 100 µmol/L, 22.2% of the respondents recommend delivery before 37 + 0 weeks of gestation due to raised bile acids of 40–99 µmol/L. Conclusions Opinions on the management of ICP in German maternity units differ widely and partly deviate by large from international standards. Reasons for this may be the lack of a national guideline and the low awareness due to the rarity of the disease on the one hand and the very slow dynamics in evidence generation and thus the uncertainty about the actual risks and optimal management on the other. The present data highlight the need for further research and clinical guidelines to standardize and optimize treatment based on the best available evidence.

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Maternal and Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis

Abstract: Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of

Cited by 11 publications

References 9 publications

Obstetric Cholestasis among Pregnant Women Visiting a Tertiary Care Centre

Obstetric Cholestasis among Pregnant Women Visiting a Tertiary Care Centre

Management Multiple Uterine Myoma in Pregnancy: A Case Report

Intrahepatic cholestasis of pregnancy: an evaluation of obstetric management in German maternity units

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