Seçil Kurtulmuş1, Esra Bahar Gür2, Deniz Öztekin3, Ebru Şahin Güleç3, Duygu Okyay3, İbrahim Gülhan3. 1. Department of Obstetrics and Gynecology, Kâtip Çelebi University Faculty of Medicine, İzmir, Turkey. 2. Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey. 3. Department of Obstetrics and Gynecology, Aegean Maternity and Teaching Hospital, İzmir, Turkey.
Abstract
OBJECTIVE: The aim of this study was to evaluate changes in fetal cardiac and peripheral circulation in pregnancies complicated with intrahepatic cholestasis. MATERIAL AND METHODS: The Doppler examination results of 22 pregnant subjects complicated with intrahepatic cholestasis of pregnancy (ICP) and 44 healthy controls were compared. The parameters of fetal cardiac circulation were pulmonary artery and aortic (Ao) peak systolic velocity (PSV), pulmonary vein (Pv), peak velocity index (PVI) and pulsatility index (PI), mitral valve (MV) and tricuspid valve (TV), early diastole (E)- and atrial contraction (A)-wave peak velocity ratio (E/A), and isthmus aortic peak systolic velocity (IAo PSV). The parameters of fetal peripheral circulation were middle cerebral artery (MCA) and umbilical artery (UA) PI, resistance index (RI), systolic/diastolic (S/D) ratio. Fetal obstetric Doppler monitoring was conducted weekly before 36 weeks and biweekly after that, and the results were compared with the normal reference values for gestational age. RESULTS: The Doppler parameters of fetal cardiac and peripheral circulation did not significantly differ between the two groups. S/D ratio readings in the ICP group were significantly above 2 SD before 35 weeks of gestation. Women with ICP had increased risks of preterm delivery, neonatal unit admission, and meconium-stained amniotic fluid compared with those in the controls. CONCLUSION: Fetuses of pregnant women with ICP showed no differences in the evaluation of cardiac and peripheral Doppler measurements compared with fetuses of healthy mothers. The Doppler investigation of the umbilical artery may be useful in monitoring of pregnancies complicated by early onset intrahepatic cholestasis.
OBJECTIVE: The aim of this study was to evaluate changes in fetal cardiac and peripheral circulation in pregnancies complicated with intrahepatic cholestasis. MATERIAL AND METHODS: The Doppler examination results of 22 pregnant subjects complicated with intrahepatic cholestasis of pregnancy (ICP) and 44 healthy controls were compared. The parameters of fetal cardiac circulation were pulmonary artery and aortic (Ao) peak systolic velocity (PSV), pulmonary vein (Pv), peak velocity index (PVI) and pulsatility index (PI), mitral valve (MV) and tricuspid valve (TV), early diastole (E)- and atrial contraction (A)-wave peak velocity ratio (E/A), and isthmus aortic peak systolic velocity (IAo PSV). The parameters of fetal peripheral circulation were middle cerebral artery (MCA) and umbilical artery (UA) PI, resistance index (RI), systolic/diastolic (S/D) ratio. Fetal obstetric Doppler monitoring was conducted weekly before 36 weeks and biweekly after that, and the results were compared with the normal reference values for gestational age. RESULTS: The Doppler parameters of fetal cardiac and peripheral circulation did not significantly differ between the two groups. S/D ratio readings in the ICP group were significantly above 2 SD before 35 weeks of gestation. Women with ICP had increased risks of preterm delivery, neonatal unit admission, and meconium-stained amniotic fluid compared with those in the controls. CONCLUSION: Fetuses of pregnant women with ICP showed no differences in the evaluation of cardiac and peripheral Doppler measurements compared with fetuses of healthy mothers. The Doppler investigation of the umbilical artery may be useful in monitoring of pregnancies complicated by early onset intrahepatic cholestasis.
Entities:
Keywords:
Intrahepatic cholestasis of pregnancy; fetal Doppler; fetal cardiac circulation
Authors: Paulo Zielinsky; Antonio L Piccoli; Lucas Teixeira; Eduardo I Gus; João L Mânica; Fabíola Satler; Humberto Vaz; Luiz H Nicoloso; Stelamaris Luchese; Marlui Sheid; Silvana Marcantonio; Domingos Hatém Journal: Arq Bras Cardiol Date: 2004-01-28 Impact factor: 2.000
Authors: A J Rioseco; M B Ivankovic; A Manzur; F Hamed; S R Kato; J T Parer; A M Germain Journal: Am J Obstet Gynecol Date: 1994-03 Impact factor: 8.661