Akademik Veri Yönetim Sistemi
Jinekoloji - Obstetrik ve Neonatoloji Tıp Dergisi, cilt.20, sa.3, ss.1797-1803, 2023 (Hakemli Dergi)
Aim: To investigate the effects of serum bile acid (BA) levels and response to ursodeoxycholic
acid (UDCA) treatment on perinatal outcomes in pregnancies complicated
by intrahepatic cholestasis of pregnancy (ICP).
Materials and Method: In this retrospective study, pregnancies followed for ICP at
a tertiary center between January 2013 and January 2018 were analyzed. ICP severity
was classified according to serum BA levels as mild (<40 μmol/L), moderate
(40-99 μmol/L) and severe (≥100 μmol/L). The effects of the severity of ICP and
the positive or negative response to UDCA treatment on perinatal outcomes were
investigated.
Results: A total of 200 pregnant women diagnosed with ICP were included in the
study. Mild ICP was detected in 65% (n=130) of the patients, moderate ICP in 21%
(n=42) and severe ICP in 15% (n=28). Stillbirth occurred in 4 (2.0%) of the patients.
Spontaneous preterm birth rate was significantly higher in patients with severe ICP
compared with patients with moderate and mild ICP (p<0.001). Mean gestational
age, mean birth weight, 1st and 5th minute Apgar scores were lower, and the presence
of meconium in the amniotic fluid, need for neonatal intensive care unit and
stillbirth rates were higher in patients with severe ICP and patients who did not
respond to UDCA treatment.
Conclusion: Pregnancies complicated by ICP have an increased risk for adverse
fetal and neonatal outcomes. Maternal serum BA levels are associated with disease
severity and adverse perinatal outcomes. The clinical response to UDCA treatment
may be effective in predicting fetal and neonatal outcomes.
Key words: Cholestasis, cholestasis of pregnancy, intrahepatic cholestasis of pregnancy,
neonatal outcomes, ursodeoxycholic acid.