Does mild intrahepatic cholestasis of pregnancy require an aggressive management? Evidence from a prospective observational study focused on adverse perinatal outcomes and pathological placental findings

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Source: Journal of Maternal-Fetal and Neonatal Medicine - Category: Perinatology & Neonatology Authors: Source Type: research

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Publication date: Available online 18 February 2020Source: Best Practice &Research Clinical GastroenterologyAuthor(s): Maria Guarino, Valentina Cossiga, Filomena MoriscoAbstractAbnormal liver tests occur in 3-5% of pregnancies and show many different causes. Although alterations of liver enzymes could be a physiological phenomenon, it may also reflect potential severe liver injury, necessitating further assessment and accurate management. The work-up has to consider liver diseases specific of pregnancy and non pregnancy-related liver damage (coincidental and pre-existing to pregnancy).Pre-existing liver diseases during...
Source: Best Practice and Research Clinical Gastroenterology - Category: Gastroenterology Source Type: research
Abstract Chronic cholestatic liver disease during pregnancy is rare as diagnosis peaks late in or after reproductive years. As a consequence, there are few studies on this topic. M.Cauldwell and colleagues report maternal and fetal outcome in a retrospective case series of 61 pregnant women with primary biliary cholangitis or primary sclerosing cholangitis (BJOG 2020 xxxx). The collected time span is 20 years including ten different centres, reflecting the relative rarity of these conditions during pregnancy. PMID: 32077233 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
Authors: Gao X, Duan X, Cai H, Hu Y, Liu M, Kang K, Zhou M, Fu D, Yi W Abstract Background: The aim of this study was to describe biochemical, virological features and Mother-to child-transmission (MTCT) rate in chronic hepatitis B (CHB) women who stopped antiviral therapy before or in the early pregnancy. Methods: This was a single-center, retrospective study. Forty-three CHB women who stopped treatment before or in the early pregnancy and 103 CHB women with tenofovir disoproxil fumarate (TDF) treatment throughout pregnancy were enrolled. The virological and biochemical flares during pregnancy and postpartum perio...
Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
AbstractPurposeIntrahepatic cholestasis of pregnancy and preeclampsia are two major pregnancy complications. We aimed to investigate the association between intrahepatic cholestasis of pregnancy (ICP) and preeclampsia.MethodsSingle-center retrospective study. Study group included 180 women (162 singletons and 18 twin gestations) who were diagnosed with ICP based on clinical presentation, elevated liver enzymes and bile acids. The reference group included 1618 women (1507 singletons and 111 twin gestations) who delivered during the study period, and were matched according to age, gravidity, parity and singleton or twin gest...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionThis case highlights and adds to the growing body of evidence supporting the need for universal screening for hepatitis C in ICP patients and the potential role for repeat SBA testing, which would be a notable change from the traditional care of these individuals.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Intrahepatic cholestasis of pregnancy is a common disorder of pregnancy manifested by pruritus and elevated bile acids. The etiology of cholestasis is poorly understood and management is difficult due to the paucity of data regarding its diagnosis, treatment, and related adverse outcomes. In this article, we review the epidemiology, pathophysiology, risk factors, laboratory findings, complications, treatment, management, and current evidence surrounding intrahepatic cholestasis of pregnancy.
Source: Clinical Obstetrics and Gynecology - Category: OBGYN Tags: Liver Disease in Pregnancy Source Type: research
Abstract Phthalates, a class of widely used endocrine-disrupting chemicals (EDCs), are toxic to various organ systems in animals and humans. Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver dysfunction causing cholestasis in late pregnancy. Evidence on the associations between exposure to phthalates and ICP is still lacking. In the present study, we investigated the relationships between urinary concentrations of phthalate metabolites and the risk of ICP in a Chinese population-based birth cohort. Pregnant women participated in the Ma'anshan Birth Cohort (MABC) study in China. Seven phthalate meta...
Source: Environmental Science and Pollution Research International - Category: Environmental Health Authors: Tags: Environ Sci Pollut Res Int Source Type: research
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Source: Journal of Maternal-Fetal and Neonatal Medicine - Category: Perinatology & Neonatology Authors: Source Type: research
Recent data suggest that vaginal progesterone administered for prevention of spontaneous preterm birth (sPTB) may increase the risk of intrahepatic cholestasis of pregnancy (IHCP). However, prior studies were underpowered to detect the true effect on IHCP because they were focused on the change in sPTB risk. Moreover, in studies investigating IM progesterone, the incidence of IHCP wan not reported. We sought to utilize the large IBM MarketScan ® Commercial Claims and Encounters Database to investigate the incidence of IHCP in patients treated with vaginal or IM progesterone for the prevention of sPTB.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Oral Concurrent 6 Source Type: research
Pruritic symptoms of intrahepatic cholestasis of pregnancy (ICP) are thought to be due to accumulation of total bile acids (TBA) with improvement following ursodeoxycholic acid (UDCA) treatment. Less is known, however, about the duration of symptom improvement in women with varying degrees of disease severity. Thus, our aim was to evaluate the duration of symptom improvement in women with ICP with varying severity of ICP defined by TBA at time of diagnosis.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Poster Session II Source Type: research
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