TY  - JOUR
T1  - Intrahepatic Cholestasis of Pregnancy and Maternal-Fetal Results
TT  - Gebeliğin Intrahepatik Kolestazı ve Maternal-Fetal Sonuçları
AU  - Uzel, Kemine
AU  - Bilir, Filiz
AU  - Sarıibrahim Astepe, Bahar
AU  - Uluğ, Paşa
AU  - Arslan, Yusuf Kemal
AU  - Kiremitli, Tunay
PY  - 2022
DA  - March
Y2  - 2022
DO  - 10.26453/otjhs.1016176
JF  - Online Turkish Journal of Health Sciences
JO  - OTSBD
PB  - Oğuz KARABAY
WT  - DergiPark
SN  - 2459-1467
SP  - 68
EP  - 73
VL  - 7
IS  - 1
LA  - en
AB  - Objective: Occurring frequently after the late second trimester intrahepatic cholestasis of pregnancy (ICP) is a widespread liver disease in the period of pregnancy. The general incidence of IC depending on the geographic variations, is probably to vary from 1% to 27.6%. In the study, it was aimed to report the maternal and fetal outcomes of women with ICP at our university hospital center. Materials and Methods: The study was performed retrospectively on 44 pregnancies complicated by ICP between June 2018 and December 2020, at our Education and Research Hospital. Demographic characteristics, liver enzymes, a gestational week at diagnosis, type and time of delivery, APGAR scores at birth, and newborn weight and information about the patients included in the study were obtained from hospital records. Results: The number of primiparous women was 27 (61%). In 4 (9.1%) women had preeclampsia and 4 (9.1%) women had gestational diabetes mellitus (GDM). Only one of the neonates had Apgar at the birth 1/5, 0 and 0 respectively.Conclusion: In our study one perinatal death was observed, although no adverse maternal outcomes were observed. We recommend that ICP be managed individually. Close monitoring and active management are required in the prevention of complications.
KW  - Intrahepatic cholestasis
KW  - pregnancy
KW  - perinatal outcomes
N2  - Amaç: Sıklıkla ikinci trimesterin sonlarından itibaren ortaya çıkan intrahepatik gebelik kolestazı, gebelik döneminde görülen yaygın bir karaciğer hastalığıdır. Coğrafi varyasyonlara bağlı olarak genel insidansı %1 -%27,6 arasında değişmektedir. Bu çalışma, üniversite hastanemizde Gebeliğin İntrahepatik Kolestazı tanılı kadınların maternal ve fetal sonuçlarını bildirmeyi amaçladı. Materyal ve Metot: Çalışma Eğitim ve Araştırma Hastanemizde, Haziran 2018-Aralık 2020 tarihleri ​​arasında Gebeliğin İntrahepatik Kolestazı (GİK) ile komplike olan 44 gebede retrospektif olarak yapıldı. Çalışmaya dahil edilen olguların (n=44) demografik özellikleri, karaciğer enzimleri, tanı aldığı gebelik haftası, doğum şekli ve zamanı, doğumda APGAR skorları, yenidoğanın kilosu ve hasta bilgileri hastane kayıtlarından alındı. Bulgular: Primipar kadın sayısı 27 (%61) idi. 4 (%9,1) kadında preeklampsi ve 4 (%9,1) kadında gestasyonel diabetes mellitus (GDM) izlendi. Yenidoğanlardan sadece birinde doğumda 1. ve 5. dakika APGAR scorları sırasıyla 0 ve 0 idi.Sonuç: Çalışmamızda herhangi bir olumsuz maternal sonuç gözlenmemesine rağmen, bir perinatal ölüm izlendi. GİK'nin bireysel olarak yönetilmesini öneririz. Komplikasyonların önlenmesinde yakın takip ve aktif yönetim gereklidir.
CR  - Reyes H, Gonzalez MC, Ribalta J, et al. Prevalence of intrahepatic cholestasis of pregnancy in Chile. Ann Intern Med. 1978;88:487-493.  doi:10.7326/0003-4819-88-4-487
CR  - Wikstrom Shemer E, Marschall HU, Ludvigsson JF, Stephansson O. Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes: a 12-year population-based cohort. BJOG. 2013;120(6):717-723. doi:10.1111/1471-0528.12174
CR  - Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2009;15(17):2049-2066. doi:10.3748/wjg.15.2049
CR  - Abedin P, Weaver JB, Egginton E. Intrahepatic cholestasis of pregnancy: prevalence and ethnic distribution. Ethn Health. 1999;4(1-2):35-7. doi:10.1080/13557859998173
CR  - Lee RH, Goodwin TM, Greenspoon J, Incerpi M. The prevalence of intrahepatic cholestasis of pregnancy in a primarily Latina Los Angeles population. J Perinatol. 2006;26(9):527-532. doi:10.1038/sj.jp.7211545
CR  - Pata O, Vardareli E, Ozcan A, et al. intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with even acids. Turk J Gastroenterol. 2011;22:602-605.
CR  - Yıldırım G, Aslan H, Gedikbaşı A, et al. In intrahepatic cholestasis pregnancy outcomes. Journal of the Turkish Society of Gynecology and Obstetrics. 2007;4:250-253.
CR  - Heinonen S, Eloranta ML, Heiskanen J, et al. Maternal susceptibility locus for obstetric cholestasis maps to chromosome region 2p13 in Finnish patients. Scand J Gastroenterol. 2001;36(7):766-770. doi:10.1080/00365520119193
CR  - Bacq Y. Liver diseases unique to pregnancy: A 2010 update. Clin Res. Hepatol Gastroenterol. 2011;35:182-193. doi: 10.1016/j.clinre.2010.11.011
CR  - Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology. 2004;40(2):467-474. doi:10.1002/hep.20336
CR  - Saleh MM, Abdo KR. Intrahepatic cholestasis of pregnancy: review of the literature and evaluation of current evidence. J Womens Health. 2007;16(6):833-841. doi:10.1089/jwh.2007.0158
CR  - Gorelik J, Shevchuk A, de Swiet M, Lab M, Korchev Y, Williamson C. Comparison of the arrhythmogenic effects of tauro- and glycoconjugates of cholic acid in an in vitro study of rat cardiomyocytes. BJOG Int J Obstet Gynaecol. 2004;111(8):867–870. doi:10.1111/j.1471-0528.2004.00166.x
CR  - Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol. 2000;33(6):1012–1021.  doi: 10.1016/s0168-8278(00)80139-7
CR  - ACOG Committee Opinion No. 764: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2019;133(2):e151–e155. doi:10.1097/AOG.0000000000003083
CR  - Marathe JA, Lim WH, Metz MP, Scheil W, Dekker AG, Hague WM. A retrospective cohort review of intrahepatic cholestasis of pregnancy in a South Australian population. Eur J Obstet Gynecol Reprod Biol. 2017;218:33-38. doi:10.1016/j.ejogrb.2017.09.012
CR  - ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2013;121(4):908-910. doi:10.1097/01.AOG.0000428648.75548.00
CR  - Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: review of six national and regional guidelines. Obstet Gynecol Reprod Biol. 2018;231:180–187. doi:10.1016/j.ejogrb.2018.10.041
CR  - Geenes V, Chappell LC, Seed PT, Steer PJ, Knight M, Williamson C. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: A prospective population-based case-control study. Hepatology. 2013;59(4):1482-91. doi: 10.1002/hep.26617
CR  - Chappell LC, Bell JL, Smith A, et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Lancet. 2019;394(10201):849–860. doi:10.1016/S0140-6736(19)31270-X
CR  - Herrera CA, Manuck TA, Stoddard GJ et al. Perinatal outcomes associated with intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med. 2018;31(14):1913-1920. doi:10.1080/14767058.2017.1332036
CR  - Kohari KS, Carroll R, Capogna S et al. Outcome after implementation of a modern management strategy for intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med. 2017;30(11):1342-1346. doi:10.1080/14767058.2016.1212833
UR  - https://doi.org/10.26453/otjhs.1016176
L1  - https://dergipark.org.tr/en/download/article-file/2052281
ER  -