Obstetric cholestasis

PURPOSE: To evaluate maternal and neonatal outcomes in patients with intrahepatic cholestasis of pregnancy (ICP). METHODS: Patients who gave birth in our hospital between January 2018 and March 2022 were retrospectively reviewed from the hospital database and patient file records. The study comprised 1686 patients, 54 in the ICP group and 1632 controls. Patients who had ICP after 20 weeks of gestation and were monitored and delivered at our facility were enrolled...

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BACKGROUND: Intrahepatic cholestasis of pregnancy is a pregnancy-related liver condition that is characterized by elevated liver function tests and/or bile acids in the presence of pruritis. OBJECTIVE: The study aimed to assess the aspartate aminotransferase to Platelet Ratio Index and Fibrosis-4 Index scores in intrahepatic cholestasis of pregnancy. STUDY DESIGN: The prospective study was carried out by assessing 142 women: 71 whose pregnancies were complicated by intrahepatic cholestasis of pregnancy and 71 without intrahepatic cholestasis of pregnancy...

BACKGROUND AND AIMS: To investigate the impact of intrahepatic cholestasis of pregnancy (ICP) with hepatitis B virus (HBV) infection on pregnancy outcomes. METHODS: We selected 512 pregnant women, collected the data including maternal demographics, main adverse pregnancy outcomes and maternal HBV infected markers HBeAg and HBV-DNA loads status, then have a comparative analysis. RESULTS: There were 319 solitary ICP patients without HBV infection (Group I) and 193 ICP patients with HBV infection...

BACKGROUND: Several observational studies demonstrated that pregnant individuals with COVID-19 had a higher risk of preeclampsia and preterm birth. We aimed to determine whether women with COVID-19 diagnosis had adverse pregnancy outcomes. METHODS: A two-sample Mendelian randomization (MR) analysis in this study was used to evaluate the casual relationships between COVID-19 infection and obstetric-related diseases based on genome-wide association studies (GWAS) dataset...

Acute fatty liver of pregnancy (AFLP) is a rare, potentially fatal obstetric emergency. Due to its nonspecific signs and symptoms, there is often a delay in diagnosis and management which is associated with morbid complications and high mortality. We report a case of a 30-year-old female gravida 3 para 2 at 32 weeks gestation who presented with nausea and vomiting for two weeks, pruritis for three days, and upper abdomen pain for a day. A clinical diagnosis of HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome/obstetric cholestasis/AFLP was made...

BACKGROUND: Although pregnancy complicated by liver cirrhosis is rare, women with cirrhosis experience increased adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in women with liver cirrhosis and develop a predictive model using maternal factors for preterm birth in such pregnancies. METHODS: A retrospective analysis was conducted on pregnancy outcomes of a cirrhosis group (n = 43) and a non-cirrhosis group (n = 172) in a university hospital between 2010 and 2022...

PURPOSE: To determine the association between fetal fraction (FF) levels in cell-free fetal DNA (cffDNA) testing and adverse pregnancy outcomes. METHODS: This retrospective cohort study, conducted at a single center, involved 2063 pregnant women with normal 1st and 2nd trimester non-invasive prenatal test (NIPT) results between 2016 and 2021. Pregnancy outcomes were examined by determining the  < 4% and  < 5th percentile (3.6%) cut-off values for low fetal fraction (LFF)...

Intrahepatic cholestasis of pregnancy is associated with adverse pregnancy outcomes including intrauterine fetal demise, spontaneous preterm labor, and meconium-stained amniotic fluid. Studies have yet to determine if patients with a history of pregnancy complicated by cholestasis had an association with more adverse outcomes in a subsequent pregnancy complicated by cholestasis.   Study Design. Retrospective cohort study of multiparous, singleton, non-anomalous live gestations complicated by cholestasis at Elmhurst Hospital Center from 2005-2019...

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BACKGROUND AND AIMS: The risk of intrahepatic cholestasis of pregnancy (ICP) is increased in thiopurine exposed pregnancies. Thiopurine 'shunting', with a 6-methylmecrcaptopurine (MMP) to 6-thioguanine (TGN) ratio of >11, progresses over pregnancy, and may promote ICP development. We aimed to explore the association between thiopurine exposure and ICP, including the hypothesized impact of thiopurine shunting, and identify risk minimization strategies. METHODS: This prospective multi-centre cohort study compared thiopurine and biologic monotherapy exposed pregnant participants...

OBJECTIVE: To assess the association between aspartate aminotransferase (AST) to platelet count ratio index (APRI score), during the first and third trimesters of pregnancy and the development of intrahepatic cholestasis in pregnancy (ICP). METHODS: Case-control study was conducted. The study included patients diagnosed with ICP by elevated bile acids (n = 118) and a control group of women with symptoms such as elevated liver enzymes or pruritus with normal level of bile acids (n = 127) who attended a large tertiary teaching medical center between the years 2014 and 2021...

OBJECTIVES: We aimed to evaluate feto-maternal blood flow parameters using Doppler ultrasonography (USG) in pregnant women with intrahepatic cholestasis of pregnancy (ICP) and the effect of ursodeoxycholic acid (UDCA) treatment on these parameters. MATERIAL AND METHODS: This prospective cohort study was performed at Dr. Sami Ulus Women's and Children's Health Teaching and Research Hospital, in Turkey between September 2022 and February 2023. Sixty pregnant women, 30 with ICP disease and 30 healthy women were included in the study...

INTRODUCTION: Obstetric cholestasis is one of the most frequent hepatic disorders specific to pregnancy. It occurs commonly during the latter half of pregnancy. The data regarding this issue is rare in our settings. The aim of this study was to find out the prevalence of obstetric cholestasis among pregnant women visiting a tertiary care centre. METHODS: A descriptive cross-sectional study was conducted among pregnant women, who attended a tertiary care centre from 24 July 2022 to 24 January 2023...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is the most common obstetric liver disorder and is associated with an increased risk of iatrogenic preterm birth and adverse infant outcomes. Hence, there are several plausible pathways through which ICP could affect offspring neurodevelopment. However, to the best of our knowledge, no studies have investigated these associations. Thus, we aimed to determine whether ICP is associated with offspring neurodevelopmental conditions. METHODS AND FINDINGS: In this Swedish register-based cohort study, we included singleton non-adopted children born in Sweden between the 1st of January 1987 and the 31st of December 2010, who were resident in Sweden >5 years, with no missing covariate information, which we followed until the 31st of December 2016...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease of pregnancy. Little is known about how it specifically affects pregnancies resulting from in vitro fertilization (IVF). Our aim is to evaluate the impact of IVF on the perinatal outcomes of ICP. METHODS: A retrospective study of 242 patients with intrahepatic cholestasis of pregnancy, comprising 36 conceived through IVF and 206 spontaneous conceptions (SC), enrolled between 2019 and 2021 was carried out...

INTRODUCTION: Prevalence estimates place maternal heart illness anywhere from 0.3 to 3.5 percent. Up to 20.5% of all maternal deaths of non-obstetrical cause are attributable to cardiovascular disease. AIM: The aim of the study was the management of patients with the multidisciplinary approach to maternal cardiovascular disease and its influence on maternal and fetal outcomes in a tertiary care centre. OBJECTIVES: 1. To find out the prevalence and spectrum of heart disease in Pregnancy...

BACKGROUND: The risk factors associated with niche on the cesarean scar have been reported, however, the degree of these factors associated with large niche and the accumulation effects of these risk factors on the development of large niche are unclear. METHODS: Large niche was evaluated by transvaginal sonography during mid-follicular phase. Logistic regression model was used to assess 32 risk factors by univariate analysis. Then, a scoring model based on the screened risk factors was generated...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is characterized by skin pruritus, elevated liver enzymes, and increased serum total bile acids. Several previous studies have revealed that the fasting and ejection volumes of the gallbladder in cholestasis of pregnancy are greater than those in normal pregnancy. The goal of this study was to explore the gallbladder volume and evaluate the diagnostic and prognostic value of ultrasound in ICP. METHODS: We prospectively recruited a cohort of 60 ICP patients at the First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China from January 2020 to December 2021 and compared their data with those from healthy pregnant women (n = 60)...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a prevalent pregnancy-specific complication that presents with maternal itching and elevated serum bile acid levels. ICP is associated with unfavorable pregnancy outcomes, severely decreasing the pregnant woman's quality of life. Timely identification of ICP is crucial for effective management and improved outcomes. METHODS: We collected urine samples from 8 patients with ICP and 8 healthy individuals. We used Liquid Chromatography-Mass Spectrometry (LC-MS) to detect metabolite expression levels, then conducted a series of bioinformatic analyses to explore the potential biological meanings of differentially expressed metabolites, and preliminarily discovered several candidate biomarkers...