Perinatal complications in intrahepatic cholestasis of pregnancy
Journal Title: International Journal of Clinical Biochemistry and Research - Year 2016, Vol 3, Issue 1
Abstract
Background and Objective: Intrahepatic cholestasis of pregnancy (ICP) is seen usually in 3 rd trimester of pregnancy. Overall incidence is 1.2-1.5% of Indian pregnant women. The biochemical abnormalities often include raised liver enzymes, conjugated bilirubin and bile acids. ICP can complicate perinatal outcomes to a significant extent. The present study was conducted to find out the types and incidence of perinatal outcomes in pregnancy complicated with ICP diagnosed by abnormal LFTS (liver function tests), to help the clinician in initiating timely treatment. Materials and methods: In the present study, 51 pregnant women diagnosed with ICP and 49 number of age and gravida matched normal pregnant women were included as cases and controls respectively. LFT and Total bile acids were estimated by standard biochemical methods. Both cases and controls were followed to evaluate perinatal outcomes after 7 days of postpartum. Results: Total bilirubin (0.6 ± 0.08 Vs 0.4 ± 0.03)milligrams/decilitre*; Aspartate transaminases (48 ± 18.6 Vs 27 ± 9.5) International Units/ Litre**; Alanine transaminase (42 ± 14.2 Vs 28 ± 6.1) International Units/ Litre**; Alkaline phosphatase (251 ± 63 Vs 159 ± 58) International Units/ Litre**;Gamma glutamyl transferase (41 ± 5.2 Vs 35 ± 3.6) International Units/ Litre**; Total bile acids (12.7 ± 10.2 Vs 33.4 ± 15.6)µ mol/ Litre ; Albumin (3.3 ± 0.5 Vs 3.2 ± 0.4)grams/decilitre; Total Proteins(6.3 ± 1.2 Vs 6.1 ± 1.5)grams/decilitre were obtained in cases Vs controls. Significantly higher incidence of total complications in cases compared to controls(54.90% Vs 12.24%)*** were found which include respiratory distress(23.52 Vs 4.08)%***, meconium aspiration (9.80 Vs 2.04)%**, pre-term delivery (9.80 Vs 4.08)%*, hyperbilirubinemia (1.96 Vs 0.0)%, fetal bradycardia (7.84 Vs 2.04)%** and fetal loss(1.96 Vs 0.0)%. (*p value<0.05, **p value<0.01, ***p value ˂0.001) Conclusion: The present study found an increase in incidence of total morbidity and mortality during perinatal period in babies born to women suffering from ICP. These findings suggests estimation of total bile acids and liver enzymes for early diagnosis of pregnant women at risk, active monitoring, treatment and induction of labor around 36-38 weeks after establishment of lung maturity in pregnancy associated with ICP to prevent perinatal complications.
Authors and Affiliations
Anuva Mishra, Akshaya Kumar Rath, Srikrushna Mahapatra, Pooja Priyadarsini
Keywords
Related Articles
- EP ID EP241974
- DOI -
- Views 110
- Downloads 0
Establishment of reference range for thyroid hormones (T3, T4 & TSH) in adult female population at clinical biochemistry laboratory of GCS medical college & hospital- A descriptive study
Aim To establish reference range of T3 T4 and TSH of adult female population at Clinical Biochemistry Laboratory GCS Hospital AhmedabadMaterials and Methods The study was conducted among 151 healthy females who had under...
Dealing with seasonal pseudohypokalemia in paediatric patients due to high ambient temperature in tropical climate: A laboratory perspective
Introduction During summer 2015 we had observed a significant rise in incidence of hypokalemia in comparison to winter 20142015 We speculated these findings might have occurred as a result of delay in centrifugation duri...
Thyroid dysfunction in Elderly people with type-2 Diabetes Mellitus
Background: The prevalence of diabetes is rapidly increasing all over the world sparing no age group and some epidemiological studies indicated increase in the prevalence of thyroid disorders in elderly people. Worldwide...
‘Sunshine vitamin deficiency’ – A myth or a fact?
As we live in a country with abundant sunshine the prevalence of this sunshine vitamin deficiency is around 70-100%. Minimum thirty minutes of UV B ray exposure causes the production of 600-1000IU of vitamin D in our bod...
Current Understanding in the Measurement of Low Density Lipoprotein Cholesterol: A Comparison of Direct Measurement by Homogenous Assays versus Calculations
Background: To compare the results obtained by direct homogenous assay for LDL-C to those obtained by Friedwalds and Anandrajas formulas with the assumption that the results obtained by direct assay are most accurate. Th...