1,132 results match your criteria Intrahepatic Cholestasis of Pregnancy


Society for Maternal-Fetal Medicine (SMFM) Consult Series #56: Hepatitis C in Pregnancy: Updated Guidelines.

Am J Obstet Gynecol 2021 Jun 8. Epub 2021 Jun 8.

In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus, which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with an increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of this document is to discuss the current evidence, provide updated recommendations regarding screening, review treatment, and address management of hepatitis C virus during pregnancy. Read More

View Article and Full-Text PDF

Clinical profile and screening of exon 6 and 14 of ABCB4 gene in obstetric cholestasis patients at a tertiary care hospital in Rawalpindi, Pakistan.

J Pak Med Assoc 2021 Jun;71(6):1633-1638

Department of Livestock Production, Genetics Division, University of Veterinry and Animal Sciences, Ravi Campus, Pattoki.

Objective: Intrahepatic Cholestasis of Pregnancy (ICP) is a rare pregnancy specific disorder. Genetic variants of ABCB4 gene increase ICP risk. This study was conducted to determine frequency of ICP cases presented at a tertiary care hospital in Rawalpindi, Pakistan and to screen for genetic variants of exon 6 and 14 of ABCB4 gene in ICP cases. Read More

View Article and Full-Text PDF

Serum TBA and GCA Levels Across Pregnancy and the Gestational Age-Specific Reference Intervals for Pregnant Chinese.

Clin Lab 2021 Jun;67(6)

Background: Reference intervals of clinical laboratory indexes are the basis of interpretation of test results. While intrahepatic cholestasis of pregnancy (ICP) could severely threaten maternal and fetal health, reference intervals of the biomarkers serum total bile acids (TBA) and glycocholic acid (GCA) are unsatisfactory. The purpose of this study was to derive gestational age-specific reference intervals for serum TBA and GCA in a Chinese population to promote early diagnosis of ICP. Read More

View Article and Full-Text PDF

Pregnancy-related comorbidities and labor induction - the effectiveness and safety of dinoprostone compared to misoprostol.

Ginekol Pol 2021 Jun 9. Epub 2021 Jun 9.

Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Cracow, Poland.

Objectives: The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel.

Material And Methods: This is aretrospective cohort study conducted of 560 pregnant women. The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. Read More

View Article and Full-Text PDF

Maternal bile acid profile and subtype analysis of intrahepatic cholestasis of pregnancy.

Orphanet J Rare Dis 2021 Jun 7;16(1):259. Epub 2021 Jun 7.

The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: ICP pregnant women have a unique profile of serum bile acid metabolism, thus the early and accurate identification of ICP patients is beneficial to early appropriate treatment and improvement of pregnancy outcomes. In this study, ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS) was used to analyze the 15 types of serum bile acid profiles among patients with ICP in third trimester, patients with cholelithiasis, and patients with hepatitis B virus. The ICP diagnostic model established by partial least squares-discriminant analysis (PLS-DA) was used to screen the differential bile acids for clinical subtypes of ICP. Read More

View Article and Full-Text PDF

Metformin impairs bile acid homeostasis in ethinylestradiol-induced cholestasis in mice.

Chem Biol Interact 2021 May 28:109525. Epub 2021 May 28.

Department of Pharmacology, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic. Electronic address:

Metformin, an oral antidiabetic drug, recently demonstrated a reducing effect on bile acids (BA) plasma concentrations in one patient with intrahepatic cholestasis of pregnancy (ICP) by unknown mechanism. Therefore, the aim of the present study was to examine the effect of metformin on BA homeostasis and related molecular pathways in the liver and intestine using a mouse model of ICP. The cholestasis was induced in female C57BL/6 mice by repeated administration of ethinylestradiol (10 mg/kg BW s. Read More

View Article and Full-Text PDF

Correlative research of the incidence of preeclampsia and sperm exposure.

Arch Gynecol Obstet 2021 May 23. Epub 2021 May 23.

Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, Zhejiang, China.

Purpose: This study aimed to evaluate the incidence of preeclampsia after a long duration or a short duration of sperm exposure with the biological father.

Methods: Analyze the clinical and follow-up data of 502 single birth primigravid women in Women's Hospital, School of Medicine, Zhejiang University. They were divided into two groups according to the duration of sperm exposure with the biological father, short duration of sperm exposure (≤ 3 months) and long duration of sperm exposure (≥ 12 months). Read More

View Article and Full-Text PDF

Influence of ursodeoxycholic acid therapy on levels of fibroblast growth factor 21, adiponectin and biochemical parameters in intrahepatic cholestasis of pregnancy.

Clin Exp Hepatol 2021 Mar 25;7(1):13-24. Epub 2021 Mar 25.

Department of Histology, Cytophysiology and Embryology in Zabrze, University of Technology, Faculty of Medicine, Katowice, Poland.

The aim was to assess whether fibroblast growth factor 21 (FGF-21) and adiponectin influence intrahepatic cholestasis of pregnancy (ICP) pathogenesis and whether ursodeoxycholic acid (UDCA) has an impact on their levels. 50 pregnant women with ICP (ICP PW), 50 with uncomplicated pregnancy (HPW) and 50 healthy nonpregnant women (HW) were included. In ICP PW the first blood sample was drawn at the time of diagnosis, while in HPW it was drawn in the 28 week of pregnancy. Read More

View Article and Full-Text PDF

Idiopathic multifocal choroiditis and punctate inner choroidopathy: an evaluation in pregnancy.

Acta Ophthalmol 2021 May 19. Epub 2021 May 19.

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.

Purpose: To evaluate the clinical course of idiopathic multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC) and the efficacy and safety of treatment options during pregnancy.

Methods: Patients with MFC or PIC and a pregnancy in 2011-2019 from two academic centres were enrolled. For the most recent pregnancy, data on best-corrected visual acuity (BCVA) before and after pregnancy, relapse rate in pregnancy and postpartum period and obstetric, maternal and neonatal outcomes were collected. Read More

View Article and Full-Text PDF

Predictive factors associated with disease recurrence in patients with severe intrahepatic cholestasis of pregnancy: a retrospective study of 118 cases.

J Matern Fetal Neonatal Med 2021 May 16:1-8. Epub 2021 May 16.

Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Purpose: To compare the clinical characteristics of pregnant women and perinatal outcomes with or without recurrent severe intrahepatic cholestasis of pregnancy (sICP), and identify possible factors associated with disease recurrence.

Methods: A retrospective study of 164,603 deliveries was performed to identify pregnant women diagnosed with sICP in the previous pregnancy from January 2012 to December 2020. Eligible patients were divided into two subgroups according to the status of disease recurrence in the second pregnancy: recurrent severe ICP (r-sICP) and non-recurrent severe ICP (nr-sICP). Read More

View Article and Full-Text PDF

Alterations of the Human Gut Microbiota in Intrahepatic Cholestasis of Pregnancy.

Front Cell Infect Microbiol 2021 30;11:635680. Epub 2021 Apr 30.

Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background And Aims: Women with severe intrahepatic cholestasis of pregnancy (ICP) are at higher risks of fetal complications and without effective treatments. Changes in gut microbiota in pregnancy were found to be related to the altered intestinal bile acid composition, so we aimed to explore the alterations of microbiota in the gut of ICP patients.

Methods: A total of 90 women were recruited, including 45 ICP patients and 45 healthy controls. Read More

View Article and Full-Text PDF

A model based on routine liver tests can reliably exclude intrahepatic cholestasis of pregnancy.

Eur J Intern Med 2021 May 10. Epub 2021 May 10.

Faculty of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel. Electronic address:

Objectives: Serum bile acid (BA) levels testing is used for the diagnosis of intrahepatic cholestasis of pregnancy (ICP). We aimed to determine the performance of routine liver tests in the evaluation of ICP.

Methods: A retrospective cohort study conducted at a university hospital, including all pregnant women who underwent serum BA levels testing due to suspected ICP during 2007-2019. Read More

View Article and Full-Text PDF

Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study.

Front Med (Lausanne) 2021 21;8:657862. Epub 2021 Apr 21.

Department of Obstetrics and Gynecology, Northwest Women and Children's Hospital, Xi'an, China.

Twin pregnancies are associated with an increased risk of adverse maternal and neonatal outcomes, mainly owing to prematurity. Few studies have evaluated the risk factors for preterm birth (PTB) in Chinese population. The objective of this study is to present the short-term maternal-neonatal outcomes, investigating the potential risk factors associated with preterm birth in Chinese twin pregnancies. Read More

View Article and Full-Text PDF

New insights in diagnostic thresholds for total serum bile acid in intrahepatic cholestasis of pregnancy.

BJOG 2021 May 6. Epub 2021 May 6.

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

View Article and Full-Text PDF

From Pruritus to Cholestasis: Building a Statistical Model and Online Application to Predict a Diagnosis Prior to Bile Acid Determination.

Am J Perinatol 2021 May 2. Epub 2021 May 2.

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective:  This study aimed to create a statistical model using clinical and laboratory parameters to predict which patients presenting with pruritus in pregnancy will have elevated total bile acids (TBA) and thus, have a high risk of intrahepatic cholestasis of pregnancy (ICP).

Study Design:  Retrospective cohort study of patients presenting with pruritus in pregnancy and had TBA sent from a single public hospital from January 1, 2017, to December 31, 2017. Primary outcome is TBA ≥ 10 µmol/L. Read More

View Article and Full-Text PDF

Perinatal outcomes of neonates born from different endometrial preparation protocols after frozen embryo transfer: a retrospective cohort study.

BMC Pregnancy Childbirth 2021 Apr 29;21(1):341. Epub 2021 Apr 29.

International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No.910, Hengshan Rd., Shanghai, 200030, China.

Background: Previous studies have focused on pregnancy outcomes after frozen embryo transfer (FET) performed using different endometrial preparation protocols. Few studies have evaluated the effect of endometrial preparation on pregnancy-related complications. This study was designed to explore the association between different endometrial preparation protocols and adverse obstetric and perinatal complications after FET. Read More

View Article and Full-Text PDF

Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: a systematic review and individual participant data meta-analysis.

Lancet Gastroenterol Hepatol 2021 Apr 26. Epub 2021 Apr 26.

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.

Background: Ursodeoxycholic acid is commonly used to treat intrahepatic cholestasis of pregnancy, yet its largest trial detected minimal benefit for a composite outcome (stillbirth, preterm birth, and neonatal unit admission). We aimed to examine whether ursodeoxycholic acid affects specific adverse perinatal outcomes.

Methods: In this systematic review and individual participant data meta-analysis, we searched PubMed, Web of Science, Embase, MEDLINE, CINAHL, Global Health, MIDIRS, and Cochrane without language restrictions for relevant articles published between database inception, and Jan 1, 2020, using search terms referencing intrahepatic cholestasis of pregnancy, ursodeoxycholic acid, and perinatal outcomes. Read More

View Article and Full-Text PDF

Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy.

Lancet Gastroenterol Hepatol 2021 Apr 26. Epub 2021 Apr 26.

Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia. Electronic address:

View Article and Full-Text PDF

Intrahepatic Cholestasis of Pregnancy: Role of Baby's Sex on Itch Severity and Bile Acid Levels.

Cureus 2021 Mar 24;13(3):e14089. Epub 2021 Mar 24.

Medical Education, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA.

Background Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder of pregnancy. It occurs when bile flow from the liver is obstructed, causing bile acid to accumulate. ICP usually presents with itching that lasts for the remainder of pregnancy. Read More

View Article and Full-Text PDF

[Intrahepatic cholestasis of pregnancy].

Gynakologe 2021 Apr 20:1-16. Epub 2021 Apr 20.

Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universität Düsseldorf, Düsseldorf, Deutschland.

Intrahepatic cholestasis of pregnancy (ICP) is the most frequent pregnancy-specific liver disease. It is characterized by pruritus and an accompanying elevation of serum bile acid concentrations and/or alanine aminotransferase (ALT), which are the key parameters in the diagnosis. Despite good maternal prognosis, elevated bile acid concentration in maternal blood is an influencing factor to advers fetal outcome. Read More

View Article and Full-Text PDF

Fas, Caspase-8, and Caspase-9 pathway-mediated bile acid-induced fetal cardiomyocyte apoptosis in intrahepatic cholestasis pregnant rat models.

J Obstet Gynaecol Res 2021 Apr 12. Epub 2021 Apr 12.

Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

Aim: Intrahepatic cholestasis of pregnancy (ICP) is a specific complication in the middle and late pregnancy and has been recognized as one of the high-risk pregnancy for sudden fetal death. In this study, we aimed to investigate the role of Fas, Caspase-8, and Caspase-9 pathways in the internal relations of fetal myocardial apoptosis in ICP rat models, thus resulting in fetal intrauterine death. Furthermore, we researched whether ursodeoxycholic acid (UDCA) promoted benefits in fetal cardiomyocyte apoptosis. Read More

View Article and Full-Text PDF

Intrahepatic Cholestasis of Pregnancy Is Associated with Reduced Nitric Oxide Synthase (iNOS) in Plasma and Placentas: A Pilot Study.

Med Sci Monit 2021 Apr 13;27:e930176. Epub 2021 Apr 13.

Department of Obstetrics and Gynecology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland).

BACKGROUND Intrahepatic cholestasis of pregnancy (ICP) is a condition specific to pregnancy, leading to increased fetal morbidity and mortality. Nitric oxide synthase (iNOS) may be a factor regulating the vasodilation of blood vessels, which are relevant to ischemic-hypoxic conditions. We aimed to explore the potential relationship between iNOS and ICP. Read More

View Article and Full-Text PDF

Role of serum organic solute transporter alpha/beta and sodium taurocholate cotransporting polypeptide in intrahepatic cholestasis of pregnancy.

Ginekol Pol 2021 Apr 12. Epub 2021 Apr 12.

Department of Gastroenterology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Objectives: This study aimed to assess the role of OST-α, OST-β and NTCP in patients with ICP, with a view to determine patients with severe prognosis and to minimize adverse fetal outcomes.

Material And Methods: Sixty-nine pregnant women diagnosed with ICP and 50 healthy women were included the study. Serum OST-α, OST-β and NTCP were measured using ELISA kits. Read More

View Article and Full-Text PDF

A novel compound heterozygous mutation in ABCB4 gene in a pedigree with progressive familial intrahepatic cholestasis 3: a case report.

Ann Transl Med 2021 Mar;9(5):426

Fourth Department of Liver Disease (Difficult & Complicated Liver Diseases and Artificial Liver Center), Beijing You An Hospital, Capital Medical University, Beijing, China.

Progressive familial intrahepatic cholestasis (PFIC) includes a group of genetic autosomal recessive disorders that predominantly affects young children and results in early-onset progressive liver damage. Variations in have been shown to cause PFIC3. However, the association between genotype and clinical manifestations remains unclear. Read More

View Article and Full-Text PDF

Intrahepatic Cholestasis of Pregnancy and Associated Adverse Maternal and Fetal Outcomes: A Retrospective Case-Control Study.

Gastroenterol Res Pract 2021 25;2021:6641023. Epub 2021 Mar 25.

The Third School of Clinical Medicine, Southern Medical University, Guangzhou, 510000 Guangdong, China.

Objective: Intrahepatic cholestasis of pregnancy (ICP) is a common pregnancy-related liver disease and is associated with an increased risk of adverse neonatal outcomes. Ursodeoxycholic acid (UDCA) is the most effective treatment. This study was aimed at investigating the adverse outcomes of ICP and evaluating the effects of treatment with UDCA in patients with ICP. Read More

View Article and Full-Text PDF

Intrahepatic cholestasis of pregnancy: Association with glycaemic control in gestational diabetes.

Diabet Med 2021 Mar 30:e14574. Epub 2021 Mar 30.

Department of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark.

Aims: The aim of this study was to determine whether the metabolic glucose profile, based on glycaemic control and insulin requirements, was different in women with gestational diabetes mellitus (GDM) and intrahepatic cholestasis of pregnancy (ICP) compared to women with only GDM.

Methods: This retrospective cohort study comprised women with GDM and ICP matched with women with only GDM was undertaken at Aarhus University hospital, Denmark, from 2012 to 2019. A total of 46 cases and 184 controls were compared in relation to glycaemic control during pregnancy. Read More

View Article and Full-Text PDF

Intrahepatic Cholestasis of Pregnancy: Natural History and Current Management.

Semin Liver Dis 2021 Jan 20;41(1):103-108. Epub 2021 Jan 20.

Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri.

Intrahepatic cholestasis of pregnancy (ICP) is a common disorder in the second half of pregnancy characterized by pruritus and elevated serum bile acids (BAs) with spontaneous resolution after delivery. ICP carries a risk of adverse effects on the fetus which correlates with the degree of BA elevation. ICP occurs in genetically susceptible women as the reproductive hormones increase during pregnancy. Read More

View Article and Full-Text PDF
January 2021

Glibenclamide, ATP and metformin increases the expression of human bile salt export pump ABCB11.

F1000Res 2020 22;9:1497. Epub 2020 Dec 22.

Department of Life Sciences, South Asian University, New Delhi, Delhi, 110021, India.

Bile salt export pump (BSEP/ABCB11) is important in the maintenance of the enterohepatic circulation of bile acids and drugs. Drugs such as rifampicin and glibenclamide inhibit BSEP. Progressive familial intrahepatic cholestasis type-2, a lethal pediatric disease, some forms of intrahepatic cholestasis of pregnancy, and drug-induced cholestasis are associated with BSEP dysfunction. Read More

View Article and Full-Text PDF

Diagnostic and Prognostic Value of Long Noncoding RNAs as Potential Novel Biomarkers in Intrahepatic Cholestasis of Pregnancy.

Biomed Res Int 2021 27;2021:8858326. Epub 2021 Feb 27.

The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi 214002, China.

Long noncoding RNAs (lncRNAs) are a class of important regulators participating in various pathological processes. Until now, the role of lncRNAs in the occurrence and development of intrahepatic cholestasis of pregnancy (ICP) has rarely been investigated. The data from microarray screening revealed 58 upregulated and 85 downregulated lncRNAs and 47 upregulated and 71 downregulated mRNAs in ICP patients compared to healthy controls. Read More

View Article and Full-Text PDF

Burden of Future Liver Abnormalities in Patients With Intrahepatic Cholestasis of Pregnancy.

Am J Gastroenterol 2021 03;116(3):568-575

Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Introduction: There are limited data on the incidence, predictors, and time to future liver abnormalities in patients with intrahepatic cholestasis of pregnancy (ICP).

Methods: Single-center retrospective study of pregnant women with and without ICP who delivered from 2005 to 2009 evaluating incidence and time to future liver abnormalities. Women returning for care with liver function tests at a minimum of 6 months postpartum were included. Read More

View Article and Full-Text PDF