Pregnancy Outcome With Intrahepatic Cholestasis

Heinonen, Seppo; Kirkinen, Pertti

doi:10.1097/00006250-199908000-00006

Cited by 52 publications

(65 citation statements)

References 17 publications

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“…Despite the absence of fetal or neonatal deaths, significantly higher incidence of complications was observed in mothers diagnosed with ICP compared to the rest of the population. The increase in complications noted in the study correlate well with the findings of similar studies [2] [3] [15]- [17]. Postpartum hemorrhage and placental abruption showed the greatest increase in those with ICP, with roughly a 10 fold increase over those who had pruritus in the absence of ICP [18].…”

Section: Discussionsupporting

confidence: 87%

Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Dodampahala¹,

Pieris²,

Chandrasena³

et al. 2016

ARSci

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Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy-ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital in Colombo Sri Lanka, between 1st January 2011 to 1st January 2014, were recruited for the study. A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered questionnaire and patient records were used for data collection. Presentation, characteristics and pregnancy outcomes were assessed and compared for mothers with ICP against those with pruri-

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Section: Discussionsupporting

confidence: 87%

Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Dodampahala¹,

Pieris²,

Chandrasena³

et al. 2016

ARSci

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“…The incidence of ICP in Finland is 0.54-1.5% of pregnancies (3)(4)(5), which is the same as that in Europe on average (2). ICP may recur in 40-50% of subsequent pregnancies (1,6).…”

Section: Introductionmentioning

confidence: 70%

“…ICP has no major physical consequences except for higher frequencies of cesarean sections and inductions (5,11). Itching may be intensive and disturbing but fades quickly postpartum.…”

Section: Introductionmentioning

confidence: 99%

Unnecessary confusion about family planning after intrahepatic cholestasis of pregnancy

et al. 2012

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“…Although the prognosis for the pregnant woman is good, the condition has been associated with increased perinatal morbidity and mortality, such as preterm labour in 12% [7][8][9], fetal distress and intrauterine death in 7% [7,[10][11][12] and meconium staining of the amniotic fluid in up to 25% [7]. Interestingly, the severity of maternal symptoms does not seem to correlate with fetal prognosis.…”

Section: Ursodeoxycholic Acid Administration From the First Trimestermentioning

confidence: 99%

Ursodeoxycholic acid administration from the first trimester in case of a severe early-onset intrahepatic cholestasis of pregnancy

Berkes¹,

Nagy²,

Rigó³

2009

Clinical and Experimental Medical Journal

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Abbreviations CTG = cardiotocography; ICP = intrahepatic cholestasis of pregnancy; UDCA = ursodeoxycholic acid Intrahepatic cholestasis of pregnancy (ICP) usually presents in the third trimester and rarely before 25 weeks' gestation [1]. It is characterized by pruritus, mild jaundice [2], fat malabsorption and raised maternal liver enzymes and bile acids. The overall prevalence of the disease is estimated at 1/1000 to 1/10000 pregnancies [3]. Scandinavia (2%) and Chile (4%) have the highest prevalence [2,4]. There is no uniform agreement on the criteria for diagnosing ICP. Knox and Olans [5] assert the role of elevated liver enzymes, whereas Palma et al. [6] emphasise that the most sensitive laboratory signs are the elevated total serum bile acids. Intrahepatic cholestasis of pregnancy is characterized by pruritus, raised maternal liver enzymes and bile acids. It usually presents in the third trimester and rarely before 25 weeks. Ursodeoxycholic acid is the most promising therapy to alleviate symptoms and prevent fetal risk. However, its administration has been restricted for the last trimester as its embryotoxic effect is undetermined. We report here a case of an extremely rare, severe obstetric cholestasis with early onset treated by ursodeoxycholic acid from the 9 th week of pregnancy, the earliest ever reported in the literature. The treatment was well tolerated. At the 32 nd week urgent caesarean section was performed due to intolerable symptoms, worsening laboratory results and signs of fetal distress. A healthy newborn was delivered. It is concluded that ursodeoxycholic acid in case of a severe early-onset intrahepatic cholestasis may be started in the early pregnancy to improve maternal condition and prevent fetal complications.

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Pregnancy Outcome With Intrahepatic Cholestasis

Cited by 52 publications

References 17 publications

Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Unnecessary confusion about family planning after intrahepatic cholestasis of pregnancy

Ursodeoxycholic acid administration from the first trimester in case of a severe early-onset intrahepatic cholestasis of pregnancy

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