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https://www.readbyqxmd.com/read/27891271/intrahepatic-cholestasis-of-pregnancy-with-severe-elevation-of-bile-acids-in-the-setting-of-acute-hepatitis-c-infection
#1
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
#2
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...
November 23, 2016: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/27824743/managing-recurring-obstetric-cholestasis-with-metformin
#3
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/27799965/ursodeoxycholic-acid-and-s-adenosylmethionine-for-the-treatment-of-intrahepatic-cholestasis-of-pregnancy-a-meta-analysis
#4
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
https://www.readbyqxmd.com/read/27776845/-the-use-of-progestatives-for-the-prevention-of-spontaneous-preterm-birth
#5
E Azria
OBJECTIVES: To identify clinical situations in which progestatives used to reduce the risk of spontaneous preterm delivery and/or reduced adverse neonatal outcomes have been evaluated and identify situations in which 17OHPC or vaginal progesterone might be recommended. METHODS: Bibliographic searches were performed in the Medline and Cochrane databases with the use of a combination of keywords and text words related to "progesterone", "tocolysis", and "preterm labor" from 1956 through July 2016...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27749550/evaluating-the-effectiveness-and-safety-of-ursodeoxycholic-acid-in-treatment-of-intrahepatic-cholestasis-of-pregnancy-a-meta-analysis-a-prisma-compliant-study
#6
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)
https://www.readbyqxmd.com/read/27743861/udca-and-cdca-alleviate-17%C3%AE-ethinylestradiol-induced-cholestasis-through-pka-ampk-pathways-in-rats
#7
Xiaojiaoyang Li, Zihang Yuan, Runping Liu, Hozeifa M Hassan, Hang Yang, Rong Sun, Luyong Zhang, Zhenzhou Jiang
Estrogen-induced cholestasis, known as intrahepatic cholestasis of pregnancy (ICP), is an estrogen-related liver disease that is widely recognized as female or pregnancy-specific. Our previous findings showed that the synthetic estrogen, 17α-ethinylestradiol (EE), induced cholestatic injury through ERK1/2-LKB1-AMP-activated protein kinase (AMPK) signaling pathway and its mediated suppression of farnesoid X receptor (FXR). To investigate the role played by bile acids in EE-induced cholestasis, we evaluated the effects of chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA) and deoxycholic acid (DCA) on sandwich cultured rat primary hepatocytes (SCRHs) and an in vivo rat model...
October 12, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27677539/intrahepatic-cholestasis-of-pregnancy-in-women-with-twin-pregnancy
#8
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)...
December 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/27612221/-a-22-year-old-mother-with-severe-pruritus-and-increasing-jaundice-two-weeks-after-starting-hormonal-contraception
#9
C Guth, U Beuers, K Beckh
Intermittent cholestatic liver disease may indicate an inherited deficiency of bile salt transport proteins. Episodes of cholestasis may start during pregnancy or during use of oral contraceptives or other medication. We describe the case of a 22-year-old mother with increasing jaundice and severe pruritus two weeks after starting hormonal contraception. A few months before she was suffering from intrahepatic cholestasis of pregnancy (ICP). Liver biopsy showed bland cholestasis with canalicular bile plugs...
September 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27577705/mitochondrial-gene-expression-profiles-are-associated-with-intrahepatic-cholestasis-of-pregnancy
#10
Maria Teresa Mella, Katherine Kohari, Richard Jones, Juan Peña, Lauren Ferrara, Joanne Stone, Luca Lambertini
INTRODUCTION: Intrahepatic cholestasis of pregnancy (ICP) affects 0.2-2% of pregnant women. While the maternal clinical course of ICP is usually benign, the fetal effects can be severe spanning from spontaneous preterm birth to fetal demise to long term effects on the health of the progeny. ICP is characterized by high maternal serum levels of bile acids and placental and hepatic bile acids accumulation. Intrahepatic cholestasis, in the non-pregnant state, has been also linked to alterations of the mitochondrial activity attributed to high oxidative stress rates driven by high intracellular bile acids concentrations...
September 2016: Placenta
https://www.readbyqxmd.com/read/27542514/hepatitis-c-infection-and-intrahepatic-cholestasis-of-pregnancy-a-systematic-review-and-meta-analysis
#11
Karn Wijarnpreecha, Charat Thongprayoon, Anawin Sanguankeo, Sikarin Upala, Patompong Ungprasert, Wisit Cheungpasitporn
BACKGROUND/OBJECTIVES: Hepatitis C virus (HCV) infection is a major cause of cirrhosis worldwide. Several studies have linked HCV infection to a higher risk of developing intrahepatic cholestasis of pregnancy (ICP), but some data demonstrates contradictory results. To further investigate the association and estimated risk of ICP in patients with HCV infection, we conducted this meta-analysis to summarize all available evidence. METHODS: This study consists of two meta-analyses...
August 16, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/27452443/the-effect-of-17%C3%AE-ethynylestradiol-induced-intrahepatic-cholestasis-of-pregnancy-on-placental-p-glycoprotein-in-mice-implications-in-the-individualized-transplacental-digoxin-treatment-for-fetal-heart-failure
#12
Chuan Wang, Yi Zhang, Yalan Zhan, Chunyan Luo, Yifei Li, Dajian Qiu, Dezhi Mu, Hongyu Duan, Kaiyu Zhou, Yimin Hua
INTRODUCTION: Placental P-glycoprotein (P-gp) plays a significant role in controlling transplacental digoxin transfer rate. Investigations on P-gp regulation in placenta of women with different pregnant pathological states are of great significance to individualized transplacental digoxin treatment for fetal heart failure (FHF). This study aimed to explore the effect of 17α-ethynylestradiol induced intrahepatic cholestasis of pregnancy (ICP) on placental P-gp in mice. METHODS: ICP model in mice was induced by subcutaneous injection of 17α-ethynylestradiol dissolved in propylene glycol once daily from E12...
August 2016: Placenta
https://www.readbyqxmd.com/read/27402811/bile-acids-evoke-placental-inflammation-by-activating-gpbar1-nf-%C3%AE%C2%BAb-pathway-in-intrahepatic-cholestasis-of-pregnancy
#13
YouHua Zhang, YouDong Pan, ChangDong Lin, YaJuan Zheng, Hao Sun, HaiLong Zhang, JunLei Wang, MengYa Yuan, Tao Duan, QiaoLing Du, JianFeng Chen
Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder with potentially deleterious consequences for fetuses. Although a clear correlation between the elevated levels of maternal serum bile acids and deficient fetal outcome has been established in clinical practice, the underlying mechanisms remain elusive. Herein, we report that bile acids induce NF-κB pathway activation via G protein-coupled bile acid receptor 1 (Gpbar1), with consequent upregulation of inflammatory genes in trophoblasts, leading to aberrant leukocyte infiltration and inflammation in placenta...
July 8, 2016: Journal of Molecular Cell Biology
https://www.readbyqxmd.com/read/27324237/immunology-of-hepatic-diseases-during-pregnancy
#14
Lars Bremer, Christoph Schramm, Gisa Tiegs
The mother's immune system has to adapt to pregnancy accepting the semi-allograft fetus and preventing harmful effects to the developing child. Aberrations in feto-maternal immune adaptation may result in disease of the mother, such as liver injury. Five pregnancy-associated liver disorders have been described so far, however, little is known concerning immune alterations promoting the respective disease. These liver disorders are pre-eclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP), acute fatty liver, hyperemesis gravidarum, and intrahepatic cholestasis of pregnancy...
June 20, 2016: Seminars in Immunopathology
https://www.readbyqxmd.com/read/27246871/association-between-serum-bile-acid-profiles-and-gestational-diabetes-mellitus-a-targeted-metabolomics-study
#15
Jieying Gao, Biao Xu, Xiaoqing Zhang, Yue Cui, Linlin Deng, Zhenghu Shi, Yong Shao, Min Ding
BACKGROUND: Given the potential influence of aberrant bile acid metabolism on glucose homeostasis, we hypothesized that serum bile acid metabolism is altered in gestational diabetes mellitus (GDM). We characterized the metabolic profiling changes of serum bile acids in GDM and to find the potential biomarkers for the diagnosis and differential diagnosis of GDM. METHODS: Based on ultrahigh performance liquid chromatography/hybrid quadrupole time-of-flight mass spectrometry, a targeted metabolomics study that involved targeted and untargeted screening techniques was performed to explore the changes in serum bile acid metabolism of GDM cases, intrahepatic cholestasis of pregnancy (ICP) cases and healthy controls...
August 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27090119/role-of-amp-activated-protein-kinase-%C3%AE-1-in-17%C3%AE-ethinylestradiol-induced-cholestasis-in-rats
#16
Xiaojiaoyang Li, Runping Liu, Lan Luo, Linxi Yu, Xin Chen, Lixin Sun, Tao Wang, Phillip B Hylemon, Huiping Zhou, Zhenzhou Jiang, Luyong Zhang
Estrogen-induced cholestasis occurs in many women who are susceptible due to pregnancy or hormone replacement therapy for postmenopausal syndrome. 17α-Ethinylestradiol (EE), as a synthetic estrogen, has been widely used to study the underlying mechanisms of estrogen-induced cholestasis. Recent studies have also reported that liver kinase B1 (LKB1)-mediated activation of AMP-activated protein kinase (AMPK) plays a critical role in the regulation of canalicular network formation. However, the role of AMPK in EE-induced cholestasis remains to be determined...
April 18, 2016: Archives of Toxicology
https://www.readbyqxmd.com/read/26913826/resveratrol-reduces-matrix-metalloproteinases-and-alleviates-intrahepatic-cholestasis-of-pregnancy-in-rats
#17
Zhong Chen, Lingqing Hu, Mudan Lu, Zongji Shen
Intrahepatic cholestasis of pregnancy (ICP) is a severe liver disorder occurring specifically in pregnancy, and matrix metalloproteinase (MMP)-2 and MMP-9 were found to be elevated in ICP patients. Using ethinylestradiol-induced ICP rats as the model, we examined the effect of resveratrol on ICP symptoms such as bile flow rate, serum enzymatic activities, and TBA concentration, as well as MMP levels, and compared with the known ICP drug ursodeoxycholic acid. Both MMP-2 and MMP-9 were upregulated in ICP rats, and resveratrol treatment could inhibit the elevation of both MMPs, whereas ursodeoxycholic acid did not exhibit any effect...
April 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/26819169/frequency-of-intrahepatic-cholestasis-of-pregnancy-in-punjab-pakistan-a-single-centre-study
#18
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
https://www.readbyqxmd.com/read/26817509/is-ursodeoxycholic-acid-effective-for-intrahepatic-cholestasis-of-pregnancy
#19
Sebastián Sepúlveda Marín, Valeria Contreras Maragaño, Claudio Vera
Intrahepatic cholestasis of pregnancy is a condition associated with fetal morbidity and mortality. Ursodeoxycholic acid has been proposed as a treatment alternative, but its use remains controversial. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including eight randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded ursodeoxycholic acid reduces prematurity risk and need for admission in neonatal intensive care units...
2016: Medwave
https://www.readbyqxmd.com/read/26777584/the-protective-effect-of-ursodeoxycholic-acid-in-an-in%C3%A2-vitro-model-of-the-human-fetal-heart-occurs-via-targeting-cardiac-fibroblasts
#20
Francisca Schultz, Alveera Hasan, Anita Alvarez-Laviada, Michele Miragoli, Navneet Bhogal, Sarah Wells, Claire Poulet, Jenny Chambers, Catherine Williamson, Julia Gorelik
Bile acids are elevated in the blood of women with intrahepatic cholestasis of pregnancy (ICP) and this may lead to fetal arrhythmia, fetal hypoxia and potentially fetal death in utero. The bile acid taurocholic acid (TC) causes abnormal calcium dynamics and contraction in neonatal rat cardiomyocytes. Ursodeoxycholic acid (UDCA), a drug clinically used to treat ICP, prevents adverse effects of TC. During development, the fetus is in a state of relative hypoxia. Although this is essential for the development of the heart and vasculature, resident fibroblasts can transiently differentiate into myofibroblasts and form gap junctions with cardiomyocytes in vitro, resulting in cardiomyocyte depolarization...
January 2016: Progress in Biophysics and Molecular Biology
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