Intrahepatic cholestasis of pregnancy: relationship among serum bile acid concentrations, transaminases and bilirubin with adverse perinatal outcomes during 2020 in provincial maternal hospital
Abstract: Intrahepatic Cholestasis of Pregnancy (ICD) is a pathology associated with serious adverse perinatal outcomes. They include: spontaneous preterm birth, asphyxia or fetal distress, meconium-stained amniotic fluid and intrauterine fetal death. Our objective was to establish ra...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34919 |
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| Sumario: | Abstract:
Intrahepatic Cholestasis of Pregnancy (ICD) is a pathology associated with serious adverse perinatal outcomes. They include: spontaneous preterm birth, asphyxia or fetal distress, meconium-stained amniotic fluid and intrauterine fetal death.
Our objective was to establish rates of adverse perinatal outcomes according to serum bile acids concentrations, transaminases and bilirubin, in patients of the Obstetric Service of the Provincial Maternal Hospital during 2020.
Observational, retrospective, cross-sectional and descriptive study. Patients with a confirmed clinical and / or biochemical diagnosis of ICD were evaluated, who received follow-up and completed their pregnancy in the Obstetrics Service of the institution previously mentioned. These patients should have laboratories with serum bile acid concentrations, transaminases and bilirubins, for diagnosis, monitoring and at the time of termination of pregnancy.
38 patients with a diagnosis of ICD were included. An incidence of 1.1 out of 100 live new-borns was established. 44.73% presented low perinatal risk, 23.69% moderate risk, and 31.37% high risk, according to biochemical markers. 33.6% completed their pregnancy at 37 weeks, except for those who presented values> 40 micromol / L, even with treatment, which were completed between 32 and 6.6 weeks. Fetal and neonatal deaths were not recorded. The Apgar score at birth after a minute was of 8 +/- 1 standard deviation, and the Apgar score after 5 minutes was of 9 +/- 0.87 standard deviations. The mean weight of the newborn was 2880 grams. 73.1% did not present meconium-stained amniotic fluid. Spontaneous preterm birth occurred in 10.52% of cases.
The gestational age at the end of pregnancy is based on high serum bile acid concentrations, biochemical markers most important, together with serum levels of transaminases, to determine the severity of the pathology, monitor and define the termination of pregnancy.
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