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cholestasis obstetrics

Luca Mannini, Flavia Sorbi, Ivo Noci, Viola Ghizzoni, Federica Perelli, Mariarosaria Di Tommaso, Alberto Mattei, Massimiliano Fambrini
PURPOSE: The main aim of this study was to evaluate the incidence of endometriosis and intrahepatic cholestasis (ICP) and induction of labor in pregnant women with endometriosis compared with women without endometriosis. The secondary aim was to confirm increased incidence of already known endometriosis-related pregnancy complications in these patients. METHODS: This is a retrospective cohort study performed at a tertiary hospital between January 2009 and December 2014 to compare obstetrics outcome between women with endometriosis and women without endometriosis...
October 21, 2016: Archives of Gynecology and Obstetrics
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Jin Yan
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a specific pregnancy-related disorder without standard medical therapies. Ursodeoxycholic acid (UDCA) is the most used medicine, but the efficacy and safety of UDCA remain uncertain. Several meta-analyses had been made to assess the effects of UDCA in ICP. However, the samples were not large enough to convince obstetricians to use UDCA. We conducted a meta-analysis to evaluate the effects and safety of UDCA in patients with ICP, which included only randomized controlled trials (RCTs)...
October 2016: Medicine (Baltimore)
Dan Shan, Yayi Hu, Peiyuan Qiu, Bechu Shelley Mathew, Yun Chen, Si Li, Yuan Hu, Lijun Lin, Zhi Wang, Luping Li
The aim of the present work was to determine maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP) in twin pregnancies. All twin pregnancies delivered above 28 gestational weeks in West China Second University Hospital from January 2013 to May 2015 were included. Data on maternal demographics and obstetric complications together with fetal outcomes were collected. The risk of adverse maternal and fetal outcomes were determined in relation to ICP by crude odds ratios (OR) and adjusted ORs (aOR) with 95% confidence intervals (CI)...
September 28, 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Nalini Sharma, S Panda, Ahanthem Santa Singh
OBJECTIVE: To study the incidence, maternal, and perinatal outcomes in intrahepatic cholestasis of pregnancy with active management. MATERIALS AND METHODS: This observational study included 48 cases diagnosed as intrahepatic cholestasis of pregnancy. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcomes are studied. RESULTS: Incidence of ICP was 2...
October 2016: Journal of Obstetrics and Gynaecology of India
Elba Carballo-Núñez, Laura González-Rodríguez, Roberto González-Boubeta, Alves-Pérez María Teresa
BACKGROUND: Obstetric cholestasis has been associated with an increased risk of preterm delivery, intrapartum meconium, foetal distress and intrauterine foetal death. There is no consensus about the frequency of each of these complications or about the prognostic value of serum bile acids and transaminase levels. Bile acids levels above 40pml/L have been associated with adverse perinatal outcomes. OBJECTIVES: To determine the frequency of adverse perinatal outcomes in single pregnancies with cholestasis of pregnancy and assess the association between levels of bile acids and transaminases in maternal serum, together with peninatal outcomes...
December 2015: Ginecología y Obstetricia de México
Caroline Ovadia, Catherine Williamson
Intrahepatic cholestasis of pregnancy, also known as obstetric cholestasis, is a pruritic condition of pregnancy characterized by an underlying elevation in circulating bile acids and liver derangement, and associated with adverse fetal outcomes, such as preterm labor and stillbirth. Limited understanding of the underlying pathophysiology and mechanisms involved in adverse outcomes has previously restricted treatment options and pregnancy management. Recent advances in these research fields provide tantalizing targets to improve the care of pregnant women affected by this condition...
May 2016: Clinics in Dermatology
Niharika Mehta, Kenneth K Chen, George Kroumpouzos
This review presents the approach of the obstetric medicine physician to skin disease in pregnancy. It elaborates on common skin-related problems during gestation, such as pruritus, with or without eruption, and drug eruptions. An algorithmic approach to the differential diagnosis of pruritus in pregnancy is outlined. Also, the review focuses on how to diagnose promptly endocrinopathies presenting with skin manifestations in pregnancy, such as Addison disease, diabetes, and hyperthyroidism. The prompt diagnosis of endocrine disorders can help to optimize management and improve outcomes...
May 2016: Clinics in Dermatology
Ai-Ming Cui, Xiao-Yan Cheng, Jian-Guo Shao, Hai-Bo Li, Xu-Lin Wang, Yi Shen, Li-Jing Mao, Sheng Zhang, Hai-Yun Liu, Lei Zhang, Gang Qin
BACKGROUND: Infection with hepatitis B virus (HBV) in pregnant women may be a threat for both mothers and fetuses. This study was performed to explore the impact of maternal HBV carrier status on pregnancy outcomes. METHODS: We conducted a prospective cohort study at the Obstetrics & Gynecology Hospital of Nantong University between January 1, 2012 and September 30, 2015. A consecutive sample of 21,004 pregnant women, 513 asymptomatic HBV carriers and 20,491 non-HBV controls, was included in this study...
2016: BMC Pregnancy and Childbirth
Serdar Başaranoğlu, Elif Ağaçayak, Feyzullah Uçmak, Senem Yaman Tunç, Aysegül Deregözü, Zeynep Meltem Akkurt, Nurullah Peker, Mustafa Acet, Hatice Yüksel, Talip Gül
AIM: The present study aimed to determine the levels of total cholesterol, triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and vitamins B1 and B2 in intrahepatic cholestasis of pregnancy (ICP) patients, and to evaluate if these were involved in the pathophysiology of the disease. METHODS: The prospective randomized study included 35 pregnant patients who were admitted to the Gynecology and Obstetrics Polyclinic, Faculty of Medicine at Dicle University and who were diagnosed with ICP (Group 1), and 40 healthy pregnant women who were admitted in the same period and who had no systemic diseases that might complicate the pregnancy during the pregnancy follow-up (Group 2)...
April 6, 2016: Journal of Perinatal Medicine
Peter H Dixon, Catherine Williamson
A number of liver disorders are specific to pregnancy. Amongst these, intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC), is the commonest, affecting approximately 1 in 140 UK pregnancies. Patients commonly present in the third trimester with severe pruritus and deranged serum liver tests; bile acids are elevated, in severe cases >40 μmol/L. Although the disease is considered relatively benign for the mother, increased rates of adverse fetal outcomes, including stillbirth, are associated with ICP...
April 2016: Clinics and Research in Hepatology and Gastroenterology
Muhammad Hafeez, Asma Ansari, Saima Parveen, Amjad Salamat, Anjum Aijaz
OBJECTIVE: To find out the frequency of intrahepatic cholestasis of pregnancy and its identification parameters. METHODS: The cross-sectional observational study was conducted in the Department of Medicine and the Department of Obstetrics, Combined Military Hospital, Kharian, from October 2013 to March 2014, and comprised all pregnant patients having symptoms suggestive of intrahepatic cholestasis which was confirmed after systemic inquiry, examination and biochemical analysis...
February 2016: JPMA. the Journal of the Pakistan Medical Association
M Doret
OBJECTIVES: To propose guidelines for clinical practice for routine postnatal visit and after pathological pregnancies. MATERIALS AND METHODS: Bibliographic searches were performed with PubMed and Cochrane databases, and within international guidelines references. RESULTS: Postpartum visit should be planned 6 to 8 weeks after delivery and can be performed by an obstetrician, a gynecologist, a general practitioner or a midwife, when after normal pregnancy and delivery (Professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
N Hançerlioğullari, A Aktulay, Y Engin-Üstün, M Ş Ozkan, A Oksuzoglu, N Danişman
OBJECTIVE: Obstetric cholestasis is a cholestatic disease usually commencing in the third trimester of pregnancy and characterized by pruritus, elevation of liver enzymes, and increase in bile acids. The objective of this study was to compare the first trimester serum indicators of obstetric cholestasis with normal pregnancies. MATERIALS AND METHODS: Thirty-five patients diagnosed with obstetric cholestasis in a three-year period with first trimester biochemical assessment available were included in the study...
2015: Clinical and Experimental Obstetrics & Gynecology
Johanna Metsälä, Beata Stach-Lempinen, Mika Gissler, Johan G Eriksson, Saila Koivusalo
BACKGROUND: Overweight and obesity are well-known risk factors for several pregnancy-related complications, but the nature of the association between maternal adiposity and these complications has been less studied. The objective of the present study was to examine the shape and the magnitude of the association between maternal prepregnancy body mass index and the risk of gestational diabetes, pre-eclampsia of different severity, gestational hypertension, and obstetric cholestasis among Finnish primiparae women...
January 2016: Paediatric and Perinatal Epidemiology
Shadi Abu-Hayyeh, Caroline Ovadia, TinaMarie Lieu, Dane D Jensen, Jenny Chambers, Peter H Dixon, Anita Lövgren-Sandblom, Ruth Bolier, Dagmar Tolenaars, Andreas E Kremer, Argyro Syngelaki, Muna Noori, David Williams, Jose J G Marin, Maria J Monte, Kypros H Nicolaides, Ulrich Beuers, Ronald Oude-Elferink, Paul T Seed, Lucy Chappell, Hanns-Ulrich Marschall, Nigel W Bunnett, Catherine Williamson
UNLABELLED: A challenge in obstetrics is to distinguish pathological symptoms from those associated with normal changes of pregnancy, typified by the need to differentiate whether gestational pruritus of the skin is an early symptom of intrahepatic cholestasis of pregnancy (ICP) or due to benign pruritus gravidarum. ICP is characterized by raised serum bile acids and complicated by spontaneous preterm labor and stillbirth. A biomarker for ICP would be invaluable for early diagnosis and treatment and to enable its differentiation from other maternal diseases...
April 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Çağrı Arıoğlu Aydın, Serdar Aydın, Hasan Serdaroğlu
OBJECTIVE: To compare perinatal, neonatal outcome and congenital anomalies of multiple gestations conceived by means of assisted reproductive techniques with spontaneously conceived multiples before the limitation of number of embryo transfer. METHODS: Cases consisted of assisted reproductive technique (ART) multifetal gestations and control group comprised of spontaneously conceived multifetal gestations delivered in the same time period. Outcomes were perinatal, neonatal outcome, long-term outcomes and congenital anomalies of multiple gestations...
2016: Journal of Maternal-fetal & Neonatal Medicine
Xiaohua Liu, Mark B Landon, Yan Chen, Weiwei Cheng
OBJECTIVE: To describe perinatal outcomes of twin pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS: We conducted a retrospective cohort study of women delivered at a large tertiary obstetric center in Shanghai, China from January 2006 to May 2014. Delivery data were abstracted from medical records of all twin gestations delivered at the hospital. RESULTS: A total of 129/1922(6.7%) twin and 1190/92 273 singleton (1...
2016: Journal of Maternal-fetal & Neonatal Medicine
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No abstract text is available yet for this article.
July 2015: Zhonghua Fu Chan Ke za Zhi
Titta Joutsiniemi, Susanna Timonen, Maria Linden, Pia Suvitie, Ulla Ekblad
BACKGROUND: To exam the biochemical, obstetric management and pregnancy outcome in women with intrahepatic cholestasis of pregnancy (ICP) and treatment with ursodeoxycholic acid (UDCA). METHODS: Pregnancy outcome in patients with ICP (N = 307) was studied and patients treated with UDCA (N = 208) vs. no UDCA were compared. The data of the antenatal visits, deliveries and neonatal outcome of 307 pregnancies with ICP was collected from the hospital computerized delivery room log book...
2015: BMC Gastroenterology
A Khalil, Asma Khalil, Argyro Syngelaki, Juliana Rezende, Kypros H Nicolaides
INTRODUCTION: Women who develop pregnancy complications are more likely to develop cardiovascular disorders later in life. A history of pre-eclampsia (PE) is associated with a four-fold increased risk of hypertension and twice the risk of future ischaemic heart disease and stroke. Early identification of women at risk of developing pregnancy complications is likely to facilitate targeted antenatal surveillance and possibly intervention. Maternal ethnicity affects the risk of developing some of these complications, and so is likely to be an important variable in the risk assessment...
July 2012: Pregnancy Hypertension
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