Maximal Response to Oxytocin of the Isolated Myometrium from Pregnant Patients with Intrahepatic Cholestasis

Israël, E; Guzmán, M.; Campos, Guilherme

doi:10.3109/00016348609158391

Cited by 46 publications

(26 citation statements)

References 5 publications

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“…In vitro findings demonstrated that myometrial cell preparations from ICP women react more intensely to oxytocine than controls [68]. While human myometrial cells have an increased oxytocin-receptors expression after being incubated with cholic acid [69].…”

Section: Foetal Morbidity and Mortalitymentioning

confidence: 98%

Intrahepatic Cholestasis of Pregnancy and Bile Acids Induced Lung Injury in Newborn Infants

Zecca¹,

Luca²,

Marras³

et al. 2007

CPR

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Intrahepatic cholestasis of pregnancy (ICP) is a clinical syndrome of unknown pathophysiology, occurring during the second half of pregnancy and persisting until delivery. The incidence of ICP varies from 0.1% to 1.5% of pregnancies in Europe, North America and Australia and from 9.2% to 15.6% in South American countries such as Bolivia and Chile. This syndrome has been associated with increased foetal distress, intrauterine death, premature delivery, perinatal mortality and, more recently, with the occurrence of respiratory distress syndrome in the newborn infant. Bile acids (BA) are supposed to be the main mediators for these complications because ICP seriously impairs the placental clearance of foetal BA leading to a dangerous accumulation of these compounds within the foetus and the newborn. Cholestatic pregnancies have to be considered high risk ones, recent reports showing that BA can interfere with surfactant metabolism and are particularly harmful for the developing lung.This review summarizes existing literature data on this topic with particular emphasis on bile acids-induced lung injury. The authors discuss possible mechanisms of lung damage and highlight future research perspectives in this field.

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Section: Foetal Morbidity and Mortalitymentioning

confidence: 98%

Intrahepatic Cholestasis of Pregnancy and Bile Acids Induced Lung Injury in Newborn Infants

Zecca¹,

Luca²,

Marras³

et al. 2007

CPR

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“…18 A recent article describes that myometrial strips from healthy women show an increased response to oxytocin and an increased oxytocin-receptor expression after being incubated with cholic acid. 19 Family clustering and a large demographic variation, with the highest incidence figures of ICP reported from Chile-Bolivia and Scandinavia, support the hypothesis of a substantial hereditary component of the disease, but the molecular genetic background has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates

2004

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Intrahepatic cholestasis of pregnancy (ICP), characterized by pruritus in the second half of pregnancy, entails an increased risk to the fetus. This study was designed to determine the incidence and fetal complication rates in ICP, and to define groups at increased risk. In an prospective cohort study conducted between February 1, 1999, and January 31, 2002, all 45,485 pregnancies in a defined region of Sweden (Västra Götaland) were screened for ICP, defined as otherwise unexplained pruritus of pregnancy in combination with fasting serum bile acid levels >10 mol/L. Pruritus was reported by 937 (2.1%) women, and ICP was diagnosed in 693 (1.5%). Simple logistic regression analyses showed that the probability of fetal complications (spontaneous preterm deliveries, asphyxial events, and meconium staining of amniotic fluid, placenta, and membranes) increased by 1%-2% per additional mol/L of serum bile acids. Complementary analyses showed that fetal complications did not arise until bile acid levels were >40 mol/L. Gallstone disease and a family history of ICP were significantly (P < .001) more prevalent in the group of ICP patients with higher bile acid levels. In conclusion, we found an incidence of ICP in our population of 1.5%. From complication rates recorded prospectively, we could define a mild (81%) and a severe (19%) form of ICP, the latter with bile acid levels >40 mol/L. No increase in fetal risk was detected in ICP patients with bile acid levels < 40 mol/L, and we propose that these women be managed expectantly, which would significantly reduce the costs of medical care. I ntrahepatic cholestasis of pregnancy (ICP) is a condition characterized by pruritus in the second half of pregnancy. It persists until delivery, after which it ceases promptly. A genetic background is suggested by family clustering and demographic variations, with the highest incidences reported from Chile-Bolivia (6%-27%) and Sweden (1-1.5%). 1 ICP is associated with an increased risk of preterm delivery in 19%-60%, 2-5 intrapartum fetal distress in 22%-41%, and intrauterine fetal death (IUFD) in 0.75%-1.6% of the affected pregnancies. [3][4][5][6] The diagnostic criteria for ICP have varied over time in different reports, making complication rates difficult to compare. When, in addition to pruritus, clinical jaundice was used to define ICP, higher fetal complication rates were reported than when diagnosis was based only on elevated bile acid and transaminase levels. 2,3,6 -8 The Swedish ICP incidence figure is taken from a study using only pruritus in pregnancy as the inclusion criterion, and that study did not report increased fetal risk associated with ICP. 9 Nowadays, elevation of serum bile acids is considered to be the most appropriate laboratory parameter for diagnosis of the condition. 8,10 -12 It is reasonable to believe that ICP constitutes a continuum, ranging from light to severe forms, but there has been an absence of algorithms to identify pregnancies entailing increased fetal risk. The aims of this prospective cohort stu...

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“…It was hypothesized that cholic acid may stimulate oxytocin receptor expression. 51 PHARMACOLOGY Several medications have been studied in the treatment of intrahepatic cholestasis of pregnancy. The overarching goal of these therapies is to alter the enterohepatic circulation of bile acids in a manner that reduces their concentration in maternal serum.…”

Section: Cholestasis Of Pregnancymentioning

confidence: 99%

Cholestasis of Pregnancy

Pathak

Sheibani

Lee

2010

Obstetrics and Gynecology Clinics of North America

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Maximal Response to Oxytocin of the Isolated Myometrium from Pregnant Patients with Intrahepatic Cholestasis

Cited by 46 publications

References 5 publications

Intrahepatic Cholestasis of Pregnancy and Bile Acids Induced Lung Injury in Newborn Infants

Intrahepatic Cholestasis of Pregnancy and Bile Acids Induced Lung Injury in Newborn Infants

Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates

Cholestasis of Pregnancy

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