Intrahepatic cholestasis of pregnancy: risk factors for severe disease

Mashburn, Sarah; Schleckman, Ellen; Cackovic, Paige; Shellhaas, Cynthia; Rood, Kara M.; Ma’ayeh, Marwan

doi:10.1080/14767058.2021.1988924

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…In addition to these factors, a retrospective study of 39,244 pregnant women found that those with gestational hypertension, preeclampsia, thrombocytopenia, hyperlipidemia, and gestational diabetes mellitus (GDM) had a higher risk of ICP than others 8 . Among the ICP patients, those with GDM, a history of ICP, previous cholecystectomy, and smoking history were more likely to develop severe ICP (TBA concentration, >100 μmol/L) 9 . Moreover, women with a history of hepatobiliary diseases are more likely to experience ICP.…”

Section: Clinical Question 1: What Are the High-risk Factors Associat...mentioning

confidence: 99%

Clinical Management Guidelines for Intrahepatic Cholestasis of Pregnancy

Yu,

Yang,

2024

Maternal Fetal Med

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Intrahepatic cholestasis of pregnancy (ICP) is a significant gestational complication in late pregnancy, potentially leading to severe perinatal complications such as intrauterine fetal demise and preterm birth. The Obstetrics Group of the Gynecology and Obstetrics Branch and the Perinatal Medicine Branch of the Chinese Medical Association organized a panel of domestic experts to deliberate and propose recommendations based on domestic and international guidelines, recent evidence-based medical evidence about key clinical issues including risk factors, clinical manifestations, perinatal outcomes, diagnosis, severity grading, maternal and fetal monitoring, treatment methods, timing and methods of pregnancy termination, and postpartum follow-up for ICP, with the aim to guide its clinical diagnosis, treatment, and management.

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Section: Clinical Question 1: What Are the High-risk Factors Associat...mentioning

confidence: 99%

Clinical Management Guidelines for Intrahepatic Cholestasis of Pregnancy

Yu,

Yang,

2024

Maternal Fetal Med

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“…Participants were divided into three groups: Group A included 30 patients with a gestational age of 30 to 34 weeks with disturbed liver function tests, Group B comprised 30 patients with a gestational age of 34 to 37 weeks who had disturbed liver function tests and exhibited pruritus, and Group C included 30 healthy pregnant women who served as the control group. All participants provided written informed consent before inclusion in the study (9). Data collection involved a self-designed proforma which captured personal information, symptoms of the disease, medical and drug history, details of general and physical examination, and laboratory investigations including liver function tests.…”

Section: Methodsmentioning

confidence: 99%

Early Detection of Intrahepatic Cholestasis of Pregnancy: Correlation Between Liver Enzymes and Adverse Fetal Outcomes

Sara Abbas,

Saghir Ahmad Jafri,

Amna Iram

et al. 2024

JHRR

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Background: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that occurs in late pregnancy and leads to elevated bile acid levels in the maternal serum, posing risks to fetal health, including preterm labor and fetal distress. Understanding the relationships between liver enzyme levels and fetal outcomes can guide early diagnostic and management strategies. Objective: To evaluate the significance of early detection of ICP through routine liver enzyme tests (AST and ALT) and its correlation with adverse fetal outcomes to inform clinical practices in regions with limited access to advanced diagnostic tools. Methods: This cross-sectional study was conducted at the Ittefaq Hospital Trust, Lahore, involving 90 pregnant women categorized into three groups based on gestational age and ICP symptoms. Group A consisted of 30 women at 30-34 weeks of gestation, Group B included 30 women at 34-37 weeks, and Group C comprised 30 healthy pregnant women as controls. Serum AST and ALT levels were measured at day 0, 30, and 45. Fetal outcomes were monitored through ultrasound and medical records. Statistical analysis was performed using SPSS version 25, employing descriptive statistics and ANOVA to compare enzyme levels and fetal outcomes across groups. Results: Group 2 exhibited significantly higher mean AST levels (96.58 U/L) and ALT levels (183.10 U/L) compared to Group 1 (AST: 49.95 U/L, ALT: 100.90 U/L) and Group 3 (AST: 25.30 U/L, ALT: 35.05 U/L). Adverse fetal outcomes, including intrauterine growth restriction (IUGR), were notably higher in Group 2 (76.7%) compared to Group 1 (13.33%) and Group 3 (0%). The statistical significance was marked with a p-value < 0.05 across all comparisons. Conclusion: Elevated liver enzymes, specifically AST and ALT, are strongly associated with adverse fetal outcomes in ICP. Early detection and monitoring of these enzymes can be crucial in preventing fetal complications, particularly in resource-limited settings where traditional diagnostic measures are inaccessible.

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“…Known risk factors for the disease include preexisting hepatobiliary disease, personal or family history of ICP, and advanced maternal age 39 . In addition, women with twin pregnancies are 5 times more likely to develop ICP than women with a singleton pregnancy 40 .…”

Section: Liver Disease Specific To Pregnancy Arementioning

confidence: 99%