Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

• Published in: Ginekologia polska 2019-01, Vol.90 (4), p.217-222
• Main Authors: Çelik, Samettin, Çalışkan, Canan S., Çelik, Handan, Güçlü, Mehmet, Başbuğ, Alper
• Format: Article
• Language: English
• Subjects: Acids; Amniotic fluid; Bile; Intensive care
• ISSN: 0017-0011; 2543-6767
• DOI: 10.5603/GP.2019.0039

OBJECTIVES: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information. MATERIAL AND METHODS: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 ≥ 40 μmol/L, and Group 2: ≥ 40 μmol/L). The groups were examined for clinical characteristics and pregnancy outcomes. RESULTS: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 μmol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation. CONCLUSIONS: Foetal complications over 40 μmol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 μmol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation.