Trends in gestational age at delivery for intrahepatic cholestasis of pregnancy and adoption of society guidelines

Lagon, Elena; Soffer, Marti D.; James, Kaitlyn; Mecklai, Keizra; Li, Darrick K.; Schaefer, Esperance A.; Duzyj, Christina M.

doi:10.1016/j.ajogmf.2022.100709

Cited by 4 publications

(12 citation statements)

References 21 publications

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“…Infants born of women with ICP tend to have lower birth weight and more NICU admissions 2 . A recent retrospective review found that many of the complications associated with ICP are complications of prematurity 1 . ICP pregnancies delivered after 37 weeks are less likely to experience these adverse events 1 .…”

Section: Discussionmentioning

confidence: 99%

“…A recent retrospective review found that many of the complications associated with ICP are complications of prematurity 1 . ICP pregnancies delivered after 37 weeks are less likely to experience these adverse events 1 . Another study found that when adjusting for neonatal age, there was no association between ICP and neonatal birth weight or NICU admission 7 .…”

Section: Discussionmentioning

confidence: 99%

“…The pruritus is not associated with a rash and can affect the whole body but is often worse over the palms of the hands and soles of the feet. It is often worse at night 1 . ICP typically presents in the second or third trimester but can present as early as the first trimester and is associated with elevated liver biochemistries in up to 84% of cases in a retrospective review 2,3 …”

Section: Introductionmentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy

Roediger,

Fleckenstein

2024

Clinical Liver Disease

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy

Roediger,

Fleckenstein

2024

Clinical Liver Disease

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“…A dose-dependent bile acid impact on myometrial contractility may be responsible for spontaneous preterm labor (Herrera et al, 2018). All pregnant lambs given cholic acid had meconium-stained amniotic fluid but no other evidence of fetal distress (Lagon et al, 2022). Studies on rabbits receiving intratracheal injections of bile acids show that these injections cause eosinophilic infiltration, atelectasis, and the hyaline membrane formation (Huang et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review On Complications of Intrahepatic Cholestasis of Pregnancy

Chaudhary¹,

Anjum²,

Khan³

et al. 2022

PJMHS

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A potentially dangerous liver condition called intrahepatic cholestasis of pregnancy (ICP) can appear during pregnancy. Primarily manifesting in the third trimester, characteristic symptoms include pruritus (itching) of the soles and palms, elevated blood bile acid levels, and impaired liver function. Several medications have been demonstrated to significantly improve biochemical indicators and gestational age of birth in patients with ICP, and they also alleviate the pruritus experienced by the mother. The use of these drugs during pregnancy may have serious consequences. This systematic review aims to describe maternal and foetal outcomes related to ICP and identify major biochemical and clinical predictors of foetal problems in women diagnosed with ICP. To provide context for the current investigation, Google Scholar and PubMed were searched for articles published between 2012 and 2022. References and bibliographies were employed in manual searches in addition to internet resources. Critical Appraisal Skills Program (CASP) evaluated all selected research papers. Findings were presented using descriptive summary table besides critical analysis. Risks of adverse perinatal outcomes, such as stillbirth and early delivery, were associated with twin pregnancies with ICP. But, premature delivery and neonatal hypoxia are more common in IVF-created twin pregnancies than in naturally conceived twin births. Severe ICP effects are linked with higher risks of stillbirth, admission to a neonatal intensive care unit, and preterm delivery. Some perinatal issues are associated with a mother's serum bile acid levels rising during pregnancy. Congenital disabilities, premature birth, and postpartum bleeding are all associated with ICP. Extreme instances of ICP frequently result in the abrupt and unexpected death of the fetus inside the uterus. ICP and stillbirth develop early in twin pregnancies. Therefore, delivering at 37 weeks may not be desirable. Enhancing fetal prognosis, particularly in twin pregnancies generated through IVF, requires early and correct diagnosis and proper medical intervention. To reduce the likelihood of an indicated preterm delivery, the decision to terminate a pregnancy in pregnancies created through IVF should be made carefully. Despite the fact that there was a clear link between ICP and preeclampsia and GDM, ICP did not raise the risk of stillbirth. Bile acid levels between the mother and fetus correlate, suggesting a causative link between BA levels, prenatal problems, and bad outcomes. Keywords: Intrahepatic cholestasis of pregnancy; pregnancy outcomes; gynecology; women health

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“…Recent guidance from the Society for Maternal-Fetal Medicine suggests delivery at 36 weeks gestation for patients with serum bile acid levels exceeding 100 μmol/L. For patients with total bile acid levels below 100 μmol/L, delivery between 36 0/7 and 39 0/7 weeks of gestation is recommended [ 52 ]. Additionally, a study found that induction of labor at either 38 or 40 weeks of gestation for women with mild ICP yielded comparable obstetrical outcomes [ 53 ].…”

Section: Reviewmentioning

confidence: 99%

Navigating Perinatal Challenges: A Comprehensive Review of Cholestasis of Pregnancy and Its Impact on Maternal and Fetal Health

Abdul Waheed,

Jaiswal,

Yelne

et al. 2024

Cureus

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Cholestasis of pregnancy (CP), or intrahepatic CP (ICP), represents a condition peculiar to pregnancy, marked by impaired bile acid flow and consequent accumulation in the maternal bloodstream. Primarily emerging in the third trimester, CP is linked with considerable risks to both the mother and fetus, including heightened incidences of preterm birth, fetal distress, and stillbirth, alongside maternal complications such as intense pruritus and liver dysfunction. Despite its clinical significance, the etiology of CP, which involves genetic, hormonal, and environmental factors, remains partially understood. This comprehensive review delves into the physiology and pathophysiology of CP, outlines its clinical manifestations and diagnostic criteria, and discusses the associated maternal and fetal complications. Furthermore, it evaluates current management strategies, prognostic implications, and potential long-term effects on maternal and child health. It also explores future research directions, emphasizing the need for advancements in understanding the pathophysiology of CP, developing novel therapeutic interventions, and improving risk stratification models. By offering a thorough overview of CP, this review aims to enhance clinical awareness, guide management practices, and identify areas requiring further investigation, ultimately contributing to better health outcomes for affected women and their babies.

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Trends in gestational age at delivery for intrahepatic cholestasis of pregnancy and adoption of society guidelines

Cited by 4 publications

References 21 publications

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy

A Systematic Review On Complications of Intrahepatic Cholestasis of Pregnancy

Navigating Perinatal Challenges: A Comprehensive Review of Cholestasis of Pregnancy and Its Impact on Maternal and Fetal Health

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