Gebeliğin intrahepatik kolestazı

Yıl 2021, , 12 - 18, 28.03.2021

Özgür Arat Mustafa Akşar Harun Egemen Tolunay

https://doi.org/10.46969/ezh.749122

Öz

Gebeliğin intrahepatik kolestazı, gebelik sırasında ortaya çıkan ve gebeliğe özgü en sık görülen karaciğer hastalığıdır. Mortalite ve morbiditeye sebep olmaktadır. Bu derlemede gebelik kolestazı güncel literatür eşliğinde tartışılmıştır. 

Anahtar Kelimeler

açlık safra asiti, Kolestaz, karaciğer enzimleri, ursodeoksikolik asit, kaşıntı

Intrahepatic Cholestasis of Pregnancy

Öz

Intrahepatic cholestasis of pregnancy is the most common pregnancy-related liver disease that occurs during pregnancy. It causes mortality and morbidity. In this review, the intrahepatic cholestasis of pregnancy (ICP) is discussed with the current literature.

Anahtar Kelimeler

cholestasis, fasting bile acid, liver enzymes, Ursodeoxycholic acid, itching

Kaynakça

• Pata O, Vardareli E, Ozcan A, et al. Intrahepatic cholestasis of pregnancy: correlation of preterm delivery with bile acids. Turk J Gastroenterol 2011; 22:602-605.
• Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines. Eur J Obstet Gynecol Reprod Biol 2018; 231:180-187.
• Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology 2004; 40:467-474.
• Reyes H, Radrigan ME, Gonzalez MC, et al. Steatorrhea in patients with intrahepatic cholestasis of pregnancy. Gastroenterology 1987; 93:584-590.
• Lindor K, Lee R. Intrahepatic Cholestasis of Pregnancy, UpToDate. 2019 (available on https://www.uptodate.com/contents/intrahepatic-cholestasis-of pregnancy search=Lindor K, Lee R. Intrahepatic Cholestasis of Pregnancy, UpToDate.&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
• Huang L, Zhao A, Lew JL, et al. Farnesoid X receptor activates transcription of the phospholipid pump MDR3. J Biol Chem 2003; 278:51085-951090.
• Milkiewicz P, Gallagher R, Chambers J, Eggington E, Weaver J, Elias E. Obstetric cholestasis with elevated gamma glutamyl transpeptidase: incidence, presentation and treatment. J Gastroenterol Hepatol 2003; 18:1283-1286.
• Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000; 33:1012-1021.
• Meng LJ, Reyes H, Axelson M, et al. Progesterone metabolites and bile acids in serum of patients with intrahepatic cholestasis of pregnancy: effect of ursodeoxycholic acid therapy. Hepatology 1997; 26:1573-1579.
• Reyes H. Review: intrahepatic cholestasis. A puzzling disorder of pregnancy. J Gastroenterol Hepatol 1997; 12:211-216.
• Kauppila A, Korpela H, Mäkilä UM, Yrjänheikki E. Low serum selenium concentration and glutathione peroxidase activity in intrahepatic cholestasis of pregnancy. Br Med J (Clin Res Ed). 1987; 294(6565):150-152.
• Agostoni A, Gerli GC, Beretta L, et al. Erythrocyte antioxidant enzymes and selenium serum levels in an Andean population. Clin Chim Acta 1983; 133:153-157.
• Williamson C, Hems LM, Goulis DG, et al. Clinical outcome in a series of cases of obstetric cholestasis identified via a patient support group. BJOG 2004; 111:676-681.
• Alsulyman OM, Ouzounian JG, Ames-Castro M, Goodwin TM. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management. Am J Obstet Gynecol 1996; 175(4 Pt 1):957-960.
• Germain AM, Kato S, Carvajal JA, Valenzuela GJ, Valdes GL, Glasinovic JC. Bile acids increase response and expression of human myometrial oxytocin receptor. Am J Obstet Gynecol 2003; 189:577-582.
• Sheikh Abdul Kadir SH, Miragoli M, Abu-Hayyeh S, et al. Bile acid-induced arrhythmia is mediated by muscarinic M2 receptors in neonatal rat cardiomyocytes. PLoS One. 2010; 5(3):e9689.
• Floreani A, Carderi I, Paternoster D, et al. Hepatobiliary phospholipid transporter ABCB4, MDR3 gene variants in a large cohort of Italian women with intrahepatic cholestasis of pregnancy. Dig Liver Dis 2008; 40:366-370.
• Rook M, Vargas J, Caughey A, Bacchetti P, Rosenthal P, Bull L. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort. PLoS One 2012; 7(3):e28343.
• Brouwers L, Koster MP, Page-Christiaens GC, et al. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. Am J Obstet Gynecol 2015; 212:100.e1-7.
• Yu L, Ding Y, Huang T, Huang X. Effect of bile Acid on fetal lung in rat model of intrahepatic cholestasis of pregnancy. Int J Endocrinol 2014; 2014:308274.
• Zhang LJ, Xiang H, Ding YL. [Influence of total bile acid in maternal serum and cord blood on neonatal cardiac function from intrahepatic cholestasis of pregnancy]. Zhonghua Fu Chan Ke Za Zhi 2009; 44:188-190.
• Paumgartner G, Beuers U. Ursodeoxycholic acid in cholestatic liver disease: mechanisms of action and therapeutic use revisited. Hepatology 2002; 36:525-531.
• EASL Clinical Practice Guidelines: management of cholestatic liver diseases. J Hepatol 2009; 51:237-267.
• Mazzella G, Rizzo N, Azzaroli F, et al. Ursodeoxycholic acid administration in patients with cholestasis of pregnancy: effects on primary bile acids in babies and mothers. Hepatology 2001; 33:504-508.
• Diken Z, Usta IM, Nassar AH. A clinical approach to intrahepatic cholestasis of pregnancy. Am J Perinatol 2014; 31:1-8.
• Nicastri PL, Diaferia A, Tartagni M, Loizzi P, Fanelli M. A randomised placebo-controlled trial of ursodeoxycholic acid and S-adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy. Br J Obstet Gynaecol 1998; 105:1205-1207.
• Binder T, Salaj P, Zima T, Vítek L. Randomized prospective comparative study of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of intrahepatic cholestasis of pregnancy. J Perinat Med 2006; 34:383-391.
• 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.
• Pathak B, Sheibani L, Lee RH. Cholestasis of pregnancy. Obstet Gynecol Clin North Am 2010; 37:269-282.
• Senocak GNC, Yilmaz EPT. Maternal and Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis. Eurasian J Med 2019; 51:270-272.
• Royal College of Obstetrics and Gynecology, Green-top Guideline No 43. Obstetric Cholestasis. April 2011, available on https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_43.pdf
• Obstetricians ACo, Gynecologists. ACOG committee opinion no. 561: nonmedically indicated early-term deliveries. Obstet Gynecol 2013; 121:911.
• Lee RH, Kwok KM, Ingles S, et al. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy. Am J Perinatol 2008; 25:341-345.
• Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG 2002; 109:282-288.
• Silver RM, Parker CB, Goldenberg R, et al. Bile acids in a multicenter, population-based case-control study of stillbirth. Am J Obstet Gynecol 2014; 210:460.e1-9.
• Henderson CE, Shah RR, Gottimukkala S, Ferreira KK, Hamaoui A, Mercado R. Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy. Am J Obstet Gynecol 2014; 211:189-196.
• Olsson R, Tysk C, Aldenborg F, Holm B. Prolonged postpartum course of intrahepatic cholestasis of pregnancy. Gastroenterology 1993; 105:267-271.
• Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol 2009; 15:2049-2066.