GEBELİĞİN İNTRAHEPATİK KOLESTAZI FETAL KALP DEBİSİNDE DEĞİŞİME NEDEN OLUR MU?

Abstract

Amaç: Gebeliğin intrahepatik kolestazında (ICP) fetal kalp debisini değerlendirmeyi amaçlıyoruz. Gereçler ve yöntem: Çalışmaya 32 ICP izlenen hasta ve 42 sağlıklı gebe dahil edildi. Semptomatik gebelerde açlık safra asidi değeri >10 µmol/L saptanması ile ICP tanısı konuldu. Fetal ekokardiyografik değerlendirmeler >34 gebelik haftasında yapıldı. Gruplar arasında hastaların demografik verileri, fetal kalp debisi ve perinatal sonuçları karşılaştırıldı. Bulgular: ICP grubunda aspartat aminotransferaz (AST) ve alanin aminotransferaz (ALT) kontrol grubuna göre daha yüksekti (p<0,001 ve p<0,001). Sol kalp debisi (LCO), sağ kalp debisi (RCO) ve kombine kalp debisi (CCO) gruplar arasında benzerdi (sırasıyla p=0.430, p=0.054, ve p=0.134). ICP izlenen hastalarda serum safra asidi (SBA) >40 µmol/L olanlar, şiddetli hastalık ve diğerleri hafif hastalık olarak iki gruba ayrıldı. ICP grubunun ağır hastalığında sağ, sol ve kombine kalp debisi azalmış olsa da istatistiksel olarak anlamlı bir fark yoktu (sırasıyla p=0,666, p=0,188 ve p=0,236). Sonuç: Çalışmamızda ICP’nin fetal kalp debisi üzerinde herhangi bir olumsuz etkisi gözlemlemedik, ancak şiddetli ICP ile daha fazla çalışma yapılmalıdır.

Keywords

• Fetal kalp debisi
• gebeliğin intrahepatik kolestazı
• serum safra asidi

DOES INTRAHEPATIC CHOLESTASIS OF PREGNANCY CAUSE A DIFFERENCE IN FETAL CARDIAC OUTPUT?

Abstract

Aim: We aim to evaluate fetal cardiac output in intrahepatic cholestasis of pregnancy (ICP). Material and Method: Thirty-two patients with ICP and 42 healthy pregnant women were included in the study. The diagnosis of ICP was made by detecting fasting bile acid value >10 µmol/L in symptomatic pregnant women. Fetal echocardiographic evaluations were performed >34 weeks of gestation. Demographic data, fetal cardiac output, and perinatal outcomes of the patients were compared between the groups. Results: In the ICP group aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were higher than the control group (p<0.001 and p<0.001). The left cardiac output (LCO), right cardiac output (RCO) and combine cardiac output (CCO) were similar between the groups (p=0.430, p=0.054, and p=0.134 respectively). Patients with ICP were divided into two groups as patients with serum bile acid (SBA) >40 µmol/L, severe disease, and others mild disease. Although right, left, and combined cardiac output was decreased in the severe disease of the ICP group, there was no statistically significant difference (p=0.666, p=0.188, and p=0.236 respectively). Conclusion: In our study, we did not observe any adverse effect of ICP on fetal cardiac output, but more studies with severe ICP should be conducted.

Keywords

• Fetal cardiac output
• intrahepatic cholestasis of pregnancy
• serum bile acid

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