Cholestatic hepatosis of pregnant women: issues of etiopathogenesis, diagnosis, management

Abstract

Cholestatic hepatosis of pregnant women complicates approximately 0.2% to 2% of pregnancies and may increase the risk of pregnancy and fetal pathology. The article provides information on diagnosis, treatment methods and possible risks to pregnant women and the fetus associated with cholestatic hepatosis of pregnancy. The diagnosis of cholestatic hepatosis of pregnant women is usually based on clinical (itching) and laboratory (elevated bile acid levels) signs. Other markers that reflect liver function, such as alanine aminotransferase and aspartate aminotransferase, are also often elevated, and this requires a differential diagnosis with other pathological conditions leading to liver dysfunction. Cholestatic hepatosis of pregnant women causes an increased risk of premature birth, fetal distress, respiratory distress syndrome of the newborn and stillbirth. There is evidence that with increasing levels of bile acids increases the risk of adverse effects for newborns. Ursodeoxycholic acid therapy reduces maternal symptoms, but this therapy has not been shown to reduce risks to the fetus. Women diagnosed with cholestatic hepatosis in pregnant women have a high risk of recurrence during subsequent pregnancies and hepatobiliary disease later in life. Keywords: cholestatic hepatosis of pregnant women, intrahepatic cholestasis of pregnant women, obstetric cholestasis.