SavedAdd your journal

Journals / Yeni Tıp Dergisi / 2012 / Cilt: 29 - Sayı: 4

Intrahepatic cholestasis of pregnancy: Etiopatho-genesis, maternal and fetal impacts

Gebeliğin intrahepatik kolestazı: Etiyopatogenez, maternal ve fetal etkileri

Ayla Sargın ORUÇ
Şevki ÇELEN
Nuri DANIŞMAN
Pages
196–201
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In this article we tried to review epidemiology, clinical features, etiology, diagnosis, pharmacologic treatment and obstetric management of ICP.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy specific liver disorder characterized by maternal pruritus in the latter half of the pregnancy, raised serum bile acids and increased rates of adverse fetal outcomes.
📊
Key Findings & Data:Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterin fetal death.
💡
Conclusion & Impact:In this article we tried to review epidemiology, clinical features, etiology, diagnosis, pharmacologic treatment and obstetric management of ICP.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Epidemiyoloji · Safra asitleri ve tuzları · Kolestaz

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy specific liver disorder characterized by maternal pruritus in the latter half of the pregnancy, raised serum bile acids and increased rates of adverse fetal outcomes. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterin fetal death. The etiology of ICP is elusive but it is likely to result from the cholestatic effects of reproductive hormones and their metabolites in genetically susceptible women. The mechanisms by which fetal complications occur is also unclear. Ursodeoxycholic acid is currently the most effective treatment, but obstetric management is stil debated. In this article we tried to review epidemiology, clinical features, etiology, diagnosis, pharmacologic treatment and obstetric management of ICP.

Özet

Gebeliğin intrahepatik kolestazı (GİK); gebeliğin ikinci yarı-sında kaşıntı ve yüksek serum safra asiti konsantras-yonları ile karakterize ve ciddi fetal riskler taşıyan, gebeliğe özgü bir karaciğer fonksiyon bozukluğudur. Maternal etkiler hafif olmakla birlikte GİK‘de fetal distres, preterm doğum ve ani intrauterin ölüm sıklığında bir artış izlenmektedir. Etiyolojisi tam olarak bilinmemek-tedir ancak genetik olarak duyarlı kadınlarda reprodüktif hormonlar ve metabolitlerinin kolestatik etkilerinden kaynaklandığı düşünülmektedir. Aynı şekilde fetal komp-likasyonların da ne şekilde oluştuğu henüz net olarak anlaşılmış değildir. Farmakolojik tedavide en etkin ajan ursodeoksikolik asittir, ancak obstetrik komplikasyonların yönetiminde halen nasıl bir yol izlenmesi gerektiği açık-lığa kavuşturulamamıştır. Bu derlemede Gebeliğin intra-hepatik kolestazının epidemiyolojisi, klinik özellikleri, etiyolojisi, tanı, tedavi ve obstetrik yönetimi gözden geçirilmiştir.

🔖

Cite This Article

ORUÇ, A. S., ÇELEN, Ş., DANIŞMAN, N. (2012). Intrahepatic cholestasis of pregnancy: Etiopatho-genesis, maternal and fetal impacts. Yeni Tıp Dergisi, Cilt: 29 - Sayı: 4, 196–201. https://ajindex.com/articles/338235

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (17)

  1. Svanborg A. A study of recurrent jaundice in pregnancy. Acta Obstet Gynecol Scand 1954;33(4):434-44
  2. Thorling L. Jaundice in pregnancy; a clinical study. Acta Med Scand Suppl 1955;302:1-123
  3. Riely AC, Bacq Y. İntrahepatic cholestasis of pregnancy. Clin Liver Dis 2004;8(1):167-76
  4. Wilson B, Haverkamp A. Cholestatic Jaundice of pregnancy: new perspectives. Obstet Gynecol 1979;54(5):650-2
  5. Laıfer SA, Stiller RJ, Siddique DS, Dunston-Boone G, Whetham JC. Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy. J Matern Fetal Med 2001;10(2):131-5
  6. Berg B, Helm G, Petersohn L, Tryding N. Cholestasis of pregnancy. Clinical and labarotory studies. Acta Obstet Gynecol Scand 1986;65(2):107-13
  7. Glantz A, Mraschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology 2004;40(2):467-74
  8. Reyes H. Review: intrahepatic cholestatsis. A puzzling disorder of pregnancy. J Gatroenterol Hepatol 1997;12(3):211-6
  9. Lammert F, Mrashall HU, Glantz A, Matern S. İntrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000;33(6):1012-21
  10. Beuers U, Pusl T. İntrahepatic kolestasis of pregnancy-a heterogeneous group of pregnancy related disorders. Hepatology 2006;43 (4):647-9
  11. Brites D, Rodrigues CM, Van-Zeller H, Brito H, Silva R. Relevance of serum bile acid profile in the diagnosis of intrahepatic cholestasis of pregnancy in an high incidence area: Portugal. Eur J Obstet Gynecol Reprod Biol 1998;80(1):31-38
  12. Gonzales MC, Reyes H, Arrese M, Figueroa D, Lorca B, Andresen M, et al. İntrahepatic cholestasis of pregnancy in twin pregnancies. J Hepatol 1989;9(1):84-90
  13. Rioseco AJ, İvankovic MB, Manzur A, Hamed F, Kato SR, Parer JT, et al. Intrahepatic cholestasis of pregnancy: a retropestive case-control study of perinatal outcome. Am J Obstet Gynecol 1994;170(3):890-5
  14. Koivurova S, Hartikainen AL, Karinen L, Gissler M, Hemminki E, Martikeinen, et al. The course of pregnancy and delivery and the use of maternal healthcare services after standard IVF in Northern Finland 1990-1995. Hum Reprod 2002;17(11):2897-903
  15. Heinonen S, Kirkinen P. Pregnancy outcome in intrahepatic cholestasis. Obstet Gynecol 1999;94(2):189-93
  16. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Obsteric cholestasis, outcome with active management: a series of 70 cases. BJOG 2002;109(3):282-9
  17. Willi