Studies in Cholestasis of Pregnancy

Abstract

Women from an earlier series of cholestasis of pregnancy (CP) were called for a retrospective study to consider presence of gallstones in the gallbladder (evaluated by cholecystography), liver function tests, serum lipids and lipoproteins and the relative fatty acid composition of serum lecithin (as determined by GLC). The attendance in the retrospective study was 60%. Estimated on the total series (assuming that none of the non-responders would have a positive X-ray), the incidence of gallbladder disease was 23.7%. Among women with previous cholestasis of pregnancy and with a positive X-ray finding no characteristic changes in liver function tests or serum lipids were revealed. The women with positive X-ray had, however, a lower alpha-lipoprotein cholesterol than women with negative X-ray. A characteristic finding among women with positive X-ray was furthermore the low relative content of palmitic acid (16:0) in serum lecithin. Also women with negative X-ray had a lower relative content of palmitic acid than controls. It is suggested that the low palmitic acid content is expressive of an influence on liver lecithin synthesis pathways and that the serum lecithin fatty acid composition reflects similar changes in bile lecithin. The "basic defect" in CP influencing liver lecithin synthesis might be the primary cause for disturbed cholesterol solubility in bile and of the frequent occurrence of gallstones in CP.

Diagnosis and Therapy of Intrahepatic Cholestasis of Pregnancy

“…This supports the current view of multiple pregnancy being a risk factor for ICP [3]. In addition, ICP is associated with a predisposition for cholesterol gallstones, and there is an increased incidence of ICP among gallstone patients [27,28]. The study by Savander detected a 22 % prevalence of cholelithiasis in ICP patients.…”

Clinical grading of Intrahepatic Cholestasis Pregnancy

“…The disruption of normal bile salt function can impair fat malabsorption and vitamin K absorption resulting steatorrhea and prolonged prothrombin time may risk for postpartum hemorrhage. 39 ICP also associates with gallbladder stone, 40 and post cholecystectomy. Ultrasonography confirms diagnosis.…”

Hepatocellular enzyme glutathione S‐transferase alpha and intrahepatic cholestasis of pregnancy

“…Women with ICP have an increased risk of cholesterol gallstones in later life (8). A recent study from Finland showed an association between ICP and several liver and biliary diseases (9).…”