BACKGROUND: Intrahepatic cholestasis of pregnancy is associated with an increased risk of fetal death. The mechanism of death is unknown. CASES: The first case involved a young primipara with pruritus and a bile acid concentration of 79 mumol/dL. While undergoing fetal heart rate monitoring, the fetus had a prolonged deceleration resulting in intrauterine death. The second case involved a young multipara with cholestasis who received ursodeoxycholic acid. Her bile acid concentration improved to13 micromol/dL. At 34 weeks of gestation, she had uterine contractions with prolonged decelerations resulting in delivery of her fetus with Apgar scores of 0, 0, and 5 at 1, 5, and 10 minutes, respectively. CONCLUSION: Fetal death from intrahepatic cholestasis of pregnancy can be abrupt and not reliably predicted by the characteristics of the fetal heart rate tracing.
BACKGROUND:Intrahepatic cholestasis of pregnancy is associated with an increased risk of fetal death. The mechanism of death is unknown. CASES: The first case involved a young primipara with pruritus and a bile acid concentration of 79 mumol/dL. While undergoing fetal heart rate monitoring, the fetus had a prolonged deceleration resulting in intrauterine death. The second case involved a young multipara with cholestasis who received ursodeoxycholic acid. Her bile acid concentration improved to13 micromol/dL. At 34 weeks of gestation, she had uterine contractions with prolonged decelerations resulting in delivery of her fetus with Apgar scores of 0, 0, and 5 at 1, 5, and 10 minutes, respectively. CONCLUSION:Fetal death from intrahepatic cholestasis of pregnancy can be abrupt and not reliably predicted by the characteristics of the fetal heart rate tracing.
Authors: Jessica R Webster; Lucy Chappell; Floria Cheng; Andrew C G Breeze; Nuala Lucas; Felicity Plaat; Catherine Williamson Journal: Obstet Med Date: 2011-05-24
Authors: Robert M Silver; Corette B Parker; Robert Goldenberg; Uma M Reddy; Donald J Dudley; George R Saade; Carol J Rowland Hogue; Donald Coustan; Michael W Varner; Matthew A Koch; Deborah Conway; Radek Bukowski; Halit Pinar; Barbara Stoll; Janet Moore; Marian Willinger Journal: Am J Obstet Gynecol Date: 2013-11-08 Impact factor: 8.661
Authors: L B Manna; C Ovadia; A Lövgren-Sandblom; J Chambers; S Begum; P Seed; I Walker; L C Chappell; H-U Marschall; C Williamson Journal: BJOG Date: 2019-09-26 Impact factor: 6.531