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Cholestasis of pregnancy

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https://www.readbyqxmd.com/read/28319428/two-cases-of-first-onset-intrahepatic-cholestasis-of-pregnancy-associated-with-moderate-ovarian-hyperstimulation-syndrome-after-ivf-treatment-and-review-of-the-literature
#1
Mehmet Firat Mutlu, Koray Aslan, Ismail Guler, Ilknur Mutlu, Mehmet Erdem, Nuray Bozkurt, Ahmet Erdem
Intrahepatic cholestasis of pregnancy (ICP) is an uncommon disorder, which generally occurs in the second and third trimester of pregnancy with symptoms of pruritus. The cause of ICP is unknown but genetic, hormonal and environmental factors contribute to its pathogenesis. The aetiology of ICP is unclear but elevation in oestrogen levels thought to cause ICP is typically seen in the third trimester of pregnancy, and for this reason it is not usually considered in the differential diagnosis of pruritus and liver function disorders in the first trimester of the pregnancy...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28298162/expression-and-significance-of-dendritic-cells-and-th17-treg-in-serum-and-placental-tissues-of-patients-with-intrahepatic-cholestasis-of-pregnancy
#2
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Xiaotong Zhu
PURPOSE: Dendritic cells (DCs) are involved in immune system, which can also regulate the differentiation of T helper 17 (Th17) and regulatory T cells (Treg). DCs and Th17/Treg participate in preeclampsia and recurrent spontaneous abortion (RSA), but there is still lack of research in intrahepatic cholestasis of pregnancy (ICP). The aim was to evaluate the expression and significance of CD83(+)DCs, CD1a(+)DCs, interleukin-17 (IL-17) and IL-35 in serum and placental tissues of patients with ICP...
March 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28283263/impact-of-oocyte-donation-on%C3%A2-perinatal-outcome-in-twin-pregnancies
#3
Lucie Guilbaud, Pietro Santulli, Eva Studer, Vanessa Gayet, François Goffinet, Camille Le Ray
OBJECTIVE: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception. DESIGN: Five-year retrospective cohort study. SETTING: Tertiary university medical center. PATIENT(S): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies...
March 7, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28270873/predictors-of-fetal-and-maternal-outcome-in-the-crucible-of-hepatic-dysfunction-during-pregnancy
#4
Indrajit Suresh, Vijaykumar Tr, Nandeesh Hp
BACKGROUND: Hepatic dysfunction during pregnancy places both the mother and the fetus at risk. Investigations which are efficient, cost effective and easily available for prognostication are required to tackle this global problem. We studied the etiologies and evaluated investigations for predictive efficiency. METHODS: One hundred ninety-seven pregnant women with hepatic dysfunction during pregnancy were identified. All patients were followed up till 8 weeks after termination of pregnancy or death...
February 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28262241/hemostatic-issues-in-pregnancy-induced-liver-disease
#5
Ton Lisman, William Bernal
Liver diseases may be accompanied by profound changes in the hemostatic system including thrombocytopenia, decreased plasma levels of pro- and anticoagulants, and alterations in plasma levels of fibrinolysis. The net effect of the hemostatic changes in chronic and acute liver diseases is a hemostatic system that is in relative balance due to the simultaneous decline in pro- and antihemostatic drivers. A unique category of liver diseases are those induced by pregnancy. In acute fatty liver of pregnancy, profound hemostatic changes occur, which may be caused by a combination of liver failure and disseminated intravascular coagulation...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28074213/-intrahepatic-cholestasis-of-pregnancy-rare-but-important
#6
REVIEW
A E Kremer, K Wolf, S Ständer
Intrahepatic cholestasis of pregnancy (ICP) is a liver-specific disorder occurring in approximately 0.5-2.0% of all pregnancies with a considerable variation in certain ethnic groups. ICP usually runs a benign course for the mother and is characterized by maternal pruritus mainly in the third trimester, elevated transaminases and fasting total serum bile salts and increased fetal adverse events. The etiology of ICP is only partially understood but seems to be multifactorial. Cholestasis-inducing effects of certain female sex hormones and their metabolites play an important role in genetically susceptible women...
January 10, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28074212/-specific-dermatoses-of-pregnancy
#7
REVIEW
C M Ambros-Rudolph, M Sticherling
The specific dermatoses of pregnancy represent a heterogeneous group of inflammatory skin diseases related to pregnancy and/or the postpartum period. A clinically relevant classification has been well established over the past 10 years and includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. The hallmark of all four entities is severe pruritus that is accompanied by characteristic skin changes. While some of these dermatoses are distressing only to the mother because of pruritus, others may be associated with significant fetal risks...
January 10, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28039538/maternal-liver-elasticity-determined-by-acoustic-radiation-force-impulse-elastosonography-in-intrahepatic-cholestasis-of-pregnancy
#8
Orkun Cetin, Erbil Karaman, Harun Arslan, Ibrahim Akbudak, Recep Yildizhan, Ali Kolusari
PURPOSE: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus and impaired liver function. The objective of the study was to evaluate maternal liver elasticity by acoustic radiation force impulse (ARFI) elastosonography in ICP and to compare it with that in healthy pregnant women. METHODS: This descriptive, case-control study consisted of 33 women with healthy pregnancies and 22 women with ICP in the third trimester of gestation...
December 30, 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28009332/effect-of-intrahepatic-cholestasis-of%C3%A2-pregnancy-on-maternal-serum-screening%C3%A2-tests
#9
G G Türkmen, H Timur, Z Yilmaz, A Kirbas, K Daglar, A Tokmak, D Uygur, N Danişman
OBJECTIVE: In this study, we aimed to evaluate whether the changes in the first and second trimester maternal serum biochemical markers used for prenatal screening are associated with euploid pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS: A total of 94 pregnant women were included in this retrospective comparative study. Thirty-seven women whose pregnancy was complicated with ICP constituted the study group whereas 57 of them constituted the control group...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28007512/-the-complex-phenotype-of-arc-syndrome-a-new-case
#10
A Giraud, F Ramond, C Cremillieux, R Touraine, H Patural, J-L Stephan
ARC syndrome (arthrogryposis - renal dysfunction - cholestasis) is a rare lethal multisystemic autosomal recessive disease. A newborn of consanguineous parents of Algerian descent presented cholestatic jaundice, dehydration, and Fanconi syndrome at 10 days of life. The blood smear showed a very characteristic gray appearance of platelets. A homozygous mutation was evidenced in the VPS33B gene. This gene codes for a protein involved in trafficking of intracellular vesicles. The mutation (c.604-2A>G) present in the heterozygous state in the parents affects an invariant base of the splice acceptor site and to our knowledge has not been reported yet...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27998400/-factors-related-to-the-influence-on-congenital-malformation-of-body-surface-in-shaanxi-province
#11
J Ying, Q Lei, B W Qin, P F Qu, F L Lei, S N Dang, L X Zeng, H Yan
Objective: To investigate the influencing factors on congenital malformation of body surface. Methods: Multi-stage stratified random sampling method was adopted. A questionnaire survey was conducted among the childbearing aged women who experienced more than 28 weeks pregnancy or having definite pregnancy outcomes in Shaanxi, during 2010-2013. Results: Results from the logistic regression model showed that factors as: intrahepatic cholestasis of pregnancy (OR=21.76, 95%CI: 4.46-106.25), histories with abnormal pregnancy or reproduction (OR=11...
December 10, 2016: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/27958341/downregulation-of-peroxiredoxin-3-by-hydrophobic-bile-acid-induces-mitochondrial-dysfunction-and-cellular-senescence-in-human-trophoblasts
#12
Wei-Bin Wu, Ramkumar Menon, Yue-Ying Xu, Jiu-Ru Zhao, Yan-Lin Wang, Yuan Liu, Hui-Juan Zhang
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disorder characterised by raised bile acids in foetal-maternal circulation, which threatens perinatal health. During the progression of ICP, the effect of oxidative stress is underscored. Peroxiredoxin-3 (PRDX3) is a mitochondrial antioxidant enzyme that is crucial to balance intracellular oxidative stress. However, the role of PRDX3 in placental trophoblast cells under ICP is not fully understood. We demonstrated that the level of PRDX3 was downregulated in ICP placentas as well as bile acids-treated trophoblast cells and villous explant in vitro...
December 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27936482/intrahepatic-cholestasis-of-pregnancy-icp-case-report-and-review-of-the-literature
#13
V Keitel, C Dröge, S Stepanow, T Fehm, E Mayatepek, K Köhrer, D Häussinger
Intrahepatic cholestasis of pregnancy (ICP) represents the most common pregnancy-related liver disease in women. Women frequently present in the third trimester with pruritus and elevated serum bile acid and/or alanine transaminase levels. Clinical symptoms quickly resolve after delivery; however, recurrence in subsequent pregnancies has to be expected. Intrahepatic cholestasis of pregnancy is associated with increased perinatal complications, such as premature delivery, meconium staining of the amniotic fluid, respiratory distress, low Apgar scores, and even stillbirth...
December 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27891271/intrahepatic-cholestasis-of-pregnancy-with-severe-elevation-of-bile-acids-in-the-setting-of-acute-hepatitis-c-infection
#14
Megan L Lawlor, Agatha S Critchfield
Intrahepatic cholestasis of pregnancy (ICP) is a complication of pregnancy resulting in elevation of serum bile acid levels. ICP is often associated with underlying liver disease, including hepatitis C. Bile acids in relationship to the acute infection of hepatitis C virus have not yet been delineated in the literature. A 26-year-old gravida 4 para 2103 with dichorionic, diamniotic twin gestation and history of intravenous drug abuse developed ICP in the setting of acute hepatitis C infection. In addition to clinical symptoms of pruritus and right upper quadrant pain, she developed severe elevation in bile acids, 239 micromol/L, and transaminitis aspartate aminotransferase 1033 U/L, and alanine aminotransferase 448 U/L...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27882439/obstetric-and-perinatal-outcome-of-babies-born-from-sperm-selected-by-macs-from-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Laura Romany, Nicolas Garrido, Ana Cobo, Belen Aparicio-Ruiz, Vicente Serra, Marcos Meseguer
PURPOSE: The purpose of this study is to assess outcomes after magnetic-activated cell sorting (MACS) technology on obstetric and perinatal outcomes compared with those achieved after swim up from randomized controlled trial. METHODS: This is a two-arm, unicentric, prospective, randomized, and triple-blinded trial and has a total of 237 infertile couples, between October 2010 and January 2013. A total of 65 and 66 newborns from MACS and control group, respectively, were described...
February 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/27871465/identification-of-genes-for-normalization-of-real-time-rt-pcr-data-in-placental-tissues-from-intrahepatic-cholestasis-of-pregnancy
#16
Yanli Li, Huifang Lu, Yizhen Ji, Sufang Wu, Yongbin Yang
The selection of suitable reference genes is crucial for proper interpretation of RT-qPCR data. To date, a systematic screening for reference genes in placental tissues from intrahepatic cholestasis of pregnancy (ICP) is missing. Eighteen candidate reference genes were investigated to determine their applicability by descriptive statistics and published algorithms. HPRT1, YWHAZ and PUM1 were found to be the most stable genes and could be used for normalization in gene expression study of placentas from ICP...
December 2016: Placenta
https://www.readbyqxmd.com/read/27825922/ursodeoxycholic-acid-therapy-in-intrahepatic-cholestasis-of-pregnancy-results-in-real-world-conditions-and-factors-predictive-of-response-to-treatment
#17
Yannick Bacq, Matthieu le Besco, Anne-Isabelle Lecuyer, Chantal Gendrot, Jérôme Potin, Christian R Andres, Alexandre Aubourg
BACKGROUND: Ursodeoxycholic acid (UDCA) therapy is commonly used in intrahepatic cholestasis of pregnancy (ICP). AIM: To evaluate the efficacy and tolerance of UDCA in real-world conditions and to search for factors predictive of response to treatment. METHODS: This observational study included 98 consecutive patients suffering from pruritus during pregnancy associated with increased ALT levels or total bile acid (TBA) concentrations, without other causes of cholestasis...
January 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27824743/managing-recurring-obstetric-cholestasis-with-metformin
#18
Abdullatif Elfituri, Amanda Ali, Hassan Shehata
BACKGROUND: Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus. CASE: This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27824421/-elevated-liver-enzymes
#19
Axel Holstege
Elevated liver enzymes are a frequent finding in both symptomatic and asymptomatic patients necessitating further evaluation to clarify the underlying disease. Three different patterns of increased liver enzymes can be defined to allow for a more precise and rational further diagnostic approach. A predominant increase in transaminase activities reflects a disturbance of hepatocellular integrity which can be found in patients with viral hepatitis, genetic liver diseases like Wilson`s disease or hemochromatosis, and drug-induced liver diseases...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27799965/ursodeoxycholic-acid-and-s-adenosylmethionine-for-the-treatment-of-intrahepatic-cholestasis-of-pregnancy-a-meta-analysis
#20
REVIEW
Yang Zhang, Linlin Lu, David W Victor, Yongning Xin, Shiying Xuan
CONTEXT: An optimal therapeutic strategy has not yet been identified for the pharmacological treatment of intrahepatic cholestasis of pregnancy (ICP). The aim of this study was to evaluate the efficacy and safety of ursodeoxycholic acid (UDCA) and S-adenosylmethionine (SAMe) in the treatment of ICP, both individually and in combination. EVIDENCE ACQUISITION: A meta-analysis of all randomized controlled trials (RCTs) comparing UDCA, SAMe, and combination therapy was performed...
August 2016: Hepatitis Monthly
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