Intrahepatic Cholestasis of Pregnancy with Adverse Perinatal Outcomes
https://doi.org/10.51523/2708-6011.2019-16-4-16
Abstract
Intrahepatic cholestasis of pregnanсу is the most common liver pathology in pregnant women. This disease has complex multifactorial pathogenesis, which is based on a genetic predisposition, insufficient amount of selenium in food and an incorrect reaction of a pregnant woman's body to a normal or elevated level of sex hormones and their metabolites. The main clinical manifestation is skin itching without skin rash. Intrahepatic cholestasis of pregnanсy leads to the development of pregnancy complications, such as preterm labour, often accompanied by meconium staining of amniotic fluid. In newborns, regardless of the gestational age, it contributes to the development of severe respiratory distress syndrome. These complications during pregnancy and the perinatal period are accompanied by high perinatal morbidity and mortality. This article describes three cases of pregnancy complicated by intrahepatic cholestasis, with early neonatal death of newborns. An indepth study and identification of the possible predictors of perinatal death of newborns from mothers with intrahepatic cholestasis of pregnancy will prevent negative outcomes in the future.
About the Authors
Ya. I. Bik-MukhametovaBelarus
Bik-Mukhametova Ya.I., assistant of the Department of Obstetrics and Gynecology with the course of the Faculty of Professional Development and Retraining of the educational institution «Gomel State Medical University».
T. N. Zakharenkova
Belarus
Zakharenkova T.N., PhD, Head of the Department of Obstetrics and Gynecology with the course of the Faculty of Professional Development and Retraining of the educational institution «Gomel State Medical University».
References
1. Бик-Мухаметова ЯИ, Захаренкова ТН. Факторы риска внутрипеченочного холестаза беременных. В кн: Актуальные проблемы медицины: сб. науч. ст. Респ. науч.-практ. конф. и 26-й итоговой науч. сессии Гом. гос. мед. ун-та; 2016, 3-4 ноября. Гомель, Беларусь, 2017. с. 85-88.
2. Ozkan S, Ceylan Y, Veli Ozkan O, Yildirim S. Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2015;21(23):7134-41. doi: 10.3748/ wjg.v21.i23.7134.
3. Geenes V, Williamson С. Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2009;15(17):2049-66. doi: 10.3748/ wjg.15.2049.
4. Turunen K, Sumanen M, Haukilahti R-L, Kirkinen P, Mattila K. Good pregnancy outcome despite intrahepatic cholestasis. Scand J Prim Health Care. 2010;28(2):102-107. doi: 10.3109/ 02813431003784001
5. Zhang Y, Li F, Wang Y, Pitre A, Fang Zh, Frank MW, Calabrese C, Krausz KW, Neale G, Frase Sh, Vogel P, Rock ChO, Gonzalez FJ, Schuetza JD. Maternal bile acid transporter deficiency promotes neonatal demise. 1 Nat Commun. 2015;6:8186. doi: 10.1038/ncomms9186.
6. Herraez E, Lozano E, Poli E, Keitel V, De Luca D, Williamson C, Marin J, Macias RI. Role of macrophages in bile acid-induced inflammatory response of fetal lung during maternal cholestasis. J Mol Med. 2014;4:359-72. doi: 10.1007/s00109-013-1106-1. Epub 2013 Dec 7.
7. Rodríguez M, Moreno J, Márquez R, Eltit R, Martinez F, Sepúlveda-Martínez A, Parra-Cordero M. Increased PR Interval in Fetuses of Patients with Intrahepatic Cholestasis of Pregnancy. Fetal Diagn Ther. 2016;4:298-302. doi: https://doi.org/ 10.1159/ 000444297.
Review
For citations:
Bik-Mukhametova Ya.I., Zakharenkova T.N. Intrahepatic Cholestasis of Pregnancy with Adverse Perinatal Outcomes. Health and Ecology Issues. 2019;(4):78-84. (In Russ.) https://doi.org/10.51523/2708-6011.2019-16-4-16