Severe Intrahepatic Cholestasis of Pregnancy—Potential Mechanism by Which Fetuses Are Protected from the Hazardous Effect of Bile Acids
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
Diagnosis and Management of Women with ICP
2.2. Study Population
2.3. Specimen Collection and Handling
2.4. TBA Assay
2.5. Data
2.6. Statistical Analysis
2.7. Ethical Approval
3. Results
4. Discussion
Strength and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Age (years) at Time of Delivery a | 5.2 ± 36.5 |
Parity a | 0.9 ± 1 |
Pregestational BMI a | 3 ± 23 |
Multiple gestation b | (27) 18/5 |
ICP in previous pregnancy b | (44) 18/8 |
IUFD in previous pregnancy due to ICP b | (5.5) 18/1 |
Gestational diabetes b | 6/18 (33) |
Gestational age at diagnosis (wks.) a | 5 ± 32 |
TBA at diagnosis a (µmol/L) (range) | (94−12) 3 ± 33.4 |
Gestational age at UDCA administration | 33 ± 5.7 |
Length of treatment (days) a | 29 ± 44 (2−133) |
Maximal TBA a (µmol/L) (range) | 99.6 ± 46 (51−247) |
Second line therapy | 6/18(33) |
Maternal TBA at delivery a (µmol/L) (range) | 76.4 ± 30.3 (40−129) |
Maternal TBA at delivery >90 µmol/L. b | 4/18(22) |
Gestational age at delivery (wks.) a | 35.6 ± 1.6 |
Delivery < 37 wks. b | 16/18 (88) |
Delivery < 34 wks. b | 3/18 (17) |
Spontaneous delivery b | 1/18 (5.5) |
Cesarean section b | 5/18 (27) |
Umbilical Vein TBA a (µmol/L), (range) | 22.5 ± 8.8.(12−42) |
Umbilical artery TBA a (µmol/L), (range) | 19.6 ± 6.5 (11−30) |
Birthweight singleton (gr) a | 2614 ± 380 |
Birthweight percentile singleton a | 51 ± 22 |
Birthweight twins (gr) a | 2440 ± 466 |
Birthweight percentile twins a | 57 ± 26 |
SGA b | 0/23 |
Umbilical cord pH <7.1 b | 0/23 |
MSAF | 7/23 (30) |
Fetal asphyxia b | 0/23 |
NICU admission b | 6/23 (26) |
NICU hospitalization (days) a, (range) | 24 ± 11 (3−36) |
RDS b (gestational age at delivery, wks.) | 3/23 (13) (32−33) |
Jaundice b | 5/23 (21) |
Perinatal death b | 0/23 |
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Hershkovitz, G.; Raz, Y.; Goldinger, I.; Many, A.; Hiersch, L.; Eli, R. Severe Intrahepatic Cholestasis of Pregnancy—Potential Mechanism by Which Fetuses Are Protected from the Hazardous Effect of Bile Acids. J. Clin. Med. 2023, 12, 616. https://doi.org/10.3390/jcm12020616
Hershkovitz G, Raz Y, Goldinger I, Many A, Hiersch L, Eli R. Severe Intrahepatic Cholestasis of Pregnancy—Potential Mechanism by Which Fetuses Are Protected from the Hazardous Effect of Bile Acids. Journal of Clinical Medicine. 2023; 12(2):616. https://doi.org/10.3390/jcm12020616
Chicago/Turabian StyleHershkovitz, Gal, Yael Raz, Ilana Goldinger, Ariel Many, Liran Hiersch, and Rimon Eli. 2023. "Severe Intrahepatic Cholestasis of Pregnancy—Potential Mechanism by Which Fetuses Are Protected from the Hazardous Effect of Bile Acids" Journal of Clinical Medicine 12, no. 2: 616. https://doi.org/10.3390/jcm12020616
APA StyleHershkovitz, G., Raz, Y., Goldinger, I., Many, A., Hiersch, L., & Eli, R. (2023). Severe Intrahepatic Cholestasis of Pregnancy—Potential Mechanism by Which Fetuses Are Protected from the Hazardous Effect of Bile Acids. Journal of Clinical Medicine, 12(2), 616. https://doi.org/10.3390/jcm12020616