BACKGROUND: Bile acid levels and liver function tests may be normal at presentation in women with intrahepatic cholestasis of pregnancy. The biochemical results of patients presenting with pruritus typical for intrahepatic cholestasis of pregnancy were reviewed. METHODS: A retrospective audit of women coded as having intrahepatic cholestasis of pregnancy over a three-year period. RESULTS: One hundred and ninety-three women (1.1% of the obstetric population) presented with pruritus typical of intrahepatic cholestasis of pregnancy. Forty (21%) of these women had normal biochemistry at presentation, half subsequently developing abnormal results. Women with a history of allergic reactions were more likely to develop intrahepatic cholestasis of pregnancy. CONCLUSIONS: Normal biochemistry should not preclude a trial of ursodeoxycholic acid in women with distressing pruritus typical for intrahepatic cholestasis of pregnancy. Biochemical tests which are more sensitive and specific in the diagnosis of intrahepatic cholestasis of pregnancy would be valuable. Investigation of other populations with intrahepatic cholestasis of pregnancy regarding a possible association with atopy/allergy would be interesting.
BACKGROUND: Bile acid levels and liver function tests may be normal at presentation in women with intrahepatic cholestasis of pregnancy. The biochemical results of patients presenting with pruritus typical for intrahepatic cholestasis of pregnancy were reviewed. METHODS: A retrospective audit of women coded as having intrahepatic cholestasis of pregnancy over a three-year period. RESULTS: One hundred and ninety-three women (1.1% of the obstetric population) presented with pruritus typical of intrahepatic cholestasis of pregnancy. Forty (21%) of these women had normal biochemistry at presentation, half subsequently developing abnormal results. Women with a history of allergic reactions were more likely to develop intrahepatic cholestasis of pregnancy. CONCLUSIONS: Normal biochemistry should not preclude a trial of ursodeoxycholic acid in women with distressing pruritus typical for intrahepatic cholestasis of pregnancy. Biochemical tests which are more sensitive and specific in the diagnosis of intrahepatic cholestasis of pregnancy would be valuable. Investigation of other populations with intrahepatic cholestasis of pregnancy regarding a possible association with atopy/allergy would be interesting.
Entities:
Keywords:
Intrahepatic cholestasis of pregnancy; liver function tests; total serum bile acids; ursodeoxycholic acid
Authors: Andreas E Kremer; Ruth Bolier; Peter H Dixon; Victoria Geenes; Jenny Chambers; Dagmar Tolenaars; Carrie Ris-Stalpers; Bernhard M Kaess; Christian Rust; Joris A van der Post; Catherine Williamson; Ulrich Beuers; Ronald P J Oude Elferink Journal: J Hepatol Date: 2014-11-05 Impact factor: 25.083
Authors: Yannick Bacq; Loïc Sentilhes; Humberto B Reyes; Anna Glantz; Jurate Kondrackiene; Tomas Binder; Pier Luigi Nicastri; Anna Locatelli; Annarosa Floreani; Ismael Hernandez; Vincent Di Martino Journal: Gastroenterology Date: 2012-08-11 Impact factor: 22.682