Predicting fetal asphyxia in intrahepatic cholestasis of pregnancy

Öztekin, Deniz; Aydal, Ipek; Öztekin, Özgür; Okcu, Sabriye; Borekci, Rengin; Tınar, Şivekar

doi:10.1007/s00404-009-1052-x

Cited by 47 publications

(23 citation statements)

References 20 publications

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“…22,23 In a recent retrospective study, TBA levels and the duration of exposure to elevated bile acids were identified as independent variables for predicting asphyxia. 21 This is consistent with the findings of Glantz et al, 2 who demonstrated an association between severe ICP and asphyxial events.…”

Section: Discussionsupporting

confidence: 90%

“…Asphyxial events have been reported to occur frequently in ICP. 2,3,10,21 Bile acids have been shown to induce vasoconstriction of placental vessels, which may lead to acute hypoxia seen in stillborn fetuses. 5 In rats, bile acid derivatives have also been shown to cause cardiac dysfunction, which might be the cause of sudden deterioration of fetal cardiotocography.…”

Section: Discussionmentioning

confidence: 99%

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Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy

Oruç

Seckin

Özcan

et al. 2014

J of Obstet and Gynaecol

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy

Oruç

Seckin

Özcan

et al. 2014

J of Obstet and Gynaecol

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“…It is generally thought that maternal serum bile acid levels and fetal bile acid exposure time [16,17,18] are important prognostic factors in ICP. Our results showed that plasma CRH was negatively correlated with TBA and ALT in ICP patients, and there was a stronger correlation with TBA.…”

Section: Discussionmentioning

confidence: 99%

Reduced Plasma Corticotropin-Releasing Hormone Levels during Late Gestation in Patients with Intrahepatic Cholestasis of Pregnancy

Huang

Liu²,

He³

et al. 2014

Gynecol Obstet Invest

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Objective: Intrahepatic cholestasis of pregnancy (ICP) may lead to sudden onset of stillbirth, which most likely is related to uteroplacental insufficiency and dysregulation of the fetal blood supply. The relaxing effect of corticotropin-releasing hormone (CRH) on blood vessels was measured to examine the role of CRH in the pathogenesis of ICP. Methods: Eighty normal pregnant women and 80 ICP patients were divided into four groups of 20 cases, respectively, each based on gestational age from week 34 to 37. Radioimmunoassay was used to measure CRH in plasma samples collected from all of the subjects. Results: Plasma CRH increased markedly from week 34 to 37 in both ICP and healthy patients, but the increase was lower in the ICP group. Plasma CRH was 322 ± 61 pg/ml in mild ICP cases at 37 weeks' compared to 1,066 ± 173 pg/ml in controls (p < 0.05), but only 218 ± 128 pg/ml in severe ICP (p < 0.05). Plasma CRH was significantly lower at all other measured time points in patients with severe ICP. In ICP patients, there was a negative correlation between plasma CRH and total bile acid (TBA). Conclusion: A limited increasing CRH level and negative correlation of CRH with TBA were unveiled in ICP patients.

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“…3,4 The incidence of meconium staining of amniotic fluid in normal term pregnancy is approximately 15% and is considered to be a sign of foetal distress. 5 In ICP incidence of meconium staining of amniotic fluid has been reported to be 16-58%. ICP have reported a perinatal mortality of 10-15%.…”

Section: Causes Of Jaundice or Deranged Liver Function Tests Specificmentioning

confidence: 99%

Study to Show the Effect of Intrahepatic Cholestasis of Pregnancy on Perinatal Outcome in Uncomplicated Pregnancy

Singla¹,

Aggarwal²,

Mittal³

2016

jemds

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OBJECTIVETo study the effect of Intrahepatic Cholestasis of Pregnancy on perinatal outcome with medical management and timely intervention in the form of induction of labour or Caesarean Section and its comparison with Control group. METHODSThis prospective study was conducted on pregnant women attending the Antenatal Clinic of Outpatient and Indoor Department of Obstetrics and Gynaecology of Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi from August 2009 till July 2011; 50 Pregnant patients who developed pruritus during 2 nd and 3 rd trimester of pregnancy with or without jaundice and were having elevated total bile acids > 10 umol/L with or without deranged liver function tests were taken as cases and 50 Pregnant patients without ICP were taken as control. RESULTSIn our study, intrahepatic cholestasis was associated with:1. Increased incidence of intrapartum thick meconium staining of amniotic fluid (30% in Cases and 10% in Control). 2. The rate of induced delivery in the form of emergency caesarean section or induced labour was also high (34% in Cases and 14% in Control). 3. Increased incidence of low birth weight (<2500 gms) and low mean birth weight, i.e. 21.5% in Cases and 6% in Control group with active intervention at 37 weeks. CONCLUSIONFrom the above study we concluded that ICP is associated with increased rate of preterm delivery, caesarean sections, low birth weight babies and still birth. KEYWORDSICP, Meconium Staining, Preterm.HOW TO CITE THIS ARTICLE: Singla S, Aggarwal P, Mittal A. Study to show the effect of intrahepatic cholestasis of pregnancy on perinatal outcome in uncomplicated pregnancy.

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Predicting fetal asphyxia in intrahepatic cholestasis of pregnancy

Cited by 47 publications

References 20 publications

Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy

Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy

Reduced Plasma Corticotropin-Releasing Hormone Levels during Late Gestation in Patients with Intrahepatic Cholestasis of Pregnancy

Study to Show the Effect of Intrahepatic Cholestasis of Pregnancy on Perinatal Outcome in Uncomplicated Pregnancy

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