GEBELİĞİN İNTRAHEPATİK KOLESTAZI FETAL KALP DEBİSİNDE DEĞİŞİME NEDEN OLUR MU?

Year 2022, Volume: 19 Issue: 1, 1159 - 1163, 25.03.2022

Ezgi Turgut , Ramazan Denizli , Nihat Farisoğulları , Bedri Sakcak , Şule Göncü Ayhan , Dilek Sahin

https://doi.org/10.38136/jgon.1069557

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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