Intrahepatic cholestasis of pregnancy – selected perinatal outcomes.
Authors:
P. Kaščák; M. Hlaváčik; M. Korbeľ
Authors‘ workplace:
Gynekologicko-pôrodnícka klinika, FN Trenčín, I. gynekologicko-pôrodnícka klinika, LF UK a FNsP Bratislava
Published in:
Prakt Gyn 2010; 14(1): 36-41
Category:
Original Article
Overview
Study aim:
To compare management, treatment and perinatologic outcomes in patients with intrahepatic cholestasis of pregnancy (ICP) before and after the introduction of ursodeoxycholic acid (UDCA) into the clinical practice at the Department of Obstetrics and Gynecology of the General Hospital Trencin, Slovakia. Patient sample and methodology: Retrospective analysis of 79 deliveries by women with ICP between 1992– 1996 when the patients were not treated with UDCA (group 1) and between 1997– 2004 when UDCA at the dose of 500– 750 mg per day orally was used as the first‑line ICP therapy (group 2). The presence of pruritus made the basis for the diagnosis of ICP, together with elevated ALT or ALP levels. Collected for the analysis was the week of gestation at the disease diagnosis, the week of delivery, newborn‘s birth weight, Apgar score at 1st and 5th minute, ALT and bilirubin levels at the diagnosis and during delivery, the type of delivery and the presence of multiple pregnancies in the affected women. Results: The prevalence of ICP was the same in both groups. Treatment with UDCA significantly decreased ALT (p = 0.013) and bilirubin levels (p = 0.008), improved significantly the subjective well‑being of the affected women, delayed delivery, increased birth weight (p = 0.005) and reduced the use of the Caesarean section. No increase in congenital developmental disorders and treatment‑related adverse effects was detected in either group of women with ICP. Conclusion: UDCA may be considered as a safe first‑line treatment in women with ICP with a positive effect on the mother’s subjective well‑being and some of the perinatologic parameters.
Key words:
intrahepatic cholestasis of pregnancy – ursodeoxycholic acid – pregnancy
Sources
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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
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