Occurrence of Liver Damage and Obstetric Outcomes in Pregnant Women Diagnosed with Pruritus during Pregnancy: A Retrospective Study

Abstract

Aim. A retrospective study of the occurrence of liver damage and obstetric outcomes in pregnant women diagnosed with pruritus. Methods. The following parameters were monitored in patients: aspartate aminotransferase (AST), alanine aminotransferase, gamma-glutamyl transferase, bilirubin (direct and total), hemoglobin, platelets, serum bile acid level, age of pregnant women, parity, pregnancy weight gain, birth weight, and gestational age at delivery. A total of 107 patients were included during a five-year period (2016–2020) and classified into three groups. Group A included 17 pregnant women with pruritus without elevated liver enzymes and bilirubin. Group B included 50 pregnant women with pruritus, elevated liver enzymes, and bilirubin. Group C included 40 pregnant women with pruritus and elevated bile acids (regardless of liver enzyme levels). Results. The groups did not significantly differ in patients’ age and parity, but there was a statistically significant between-group difference in weight gain during pregnancy. The values of AST, ALT, GGT, LDH, and direct bilirubin were the highest in group B, and serum bile acids were expectedly the highest in group C. There was no statistically significant variation in the onset of labor and mode of delivery between groups. However, groups significantly differed in gestational age at delivery, newborn birthweight, and pregnancy prolongation from the onset of pruritus to delivery. Conclusion. Further study is needed to assess the pathophysiologic mechanisms underlying intrahepatic cholestasis of pregnancy as well as any significant liver damage associated with pregnancy.

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

“…Of note, the liver function is also closely associated with fetal conditions irrespective of the serum bile acid level. In pregnancies with elevated liver enzymes, the pregnancy outcome is not optimistic even when the bile acid is in an acceptable level ( Bicocca et al, 2018 ; Azzaroli et al, 2020 ; Katarey and Westbrook, 2020 ; Lao, 2020 ; Pavelic et al, 2022 ).…”