Cholestasis of pregnancy
DOI:
https://doi.org/10.5281/zenodo.1219189Keywords:
bile acids, cholestasis, pregnancy, pruritusAbstract
Cholestasis of pregnancy is a dysfunction of the liver characterized by pruritus and increased concentration of bile acids in the plasma during the second and third trimester. The cause of cholestasis of pregnancy is unknown, but it is believed to be connected to genetic factors and high values of the pregnancy hormone, which causes a disorder in the transport of bile acids in liver ducts. The leading symptom is pruritus, which is often generalized, but dominant on the palms and soles of the feet, and worsens during the night. Cholestasis of pregnancy is dangerous because it increases the risk of spontaneous preterm birth, meconium stained amniotic fluid, fetal distress, and intrauterine fetal death.
References
2. Arrese M, Macias RI, Briz O, Perez MJ, Marin JJ. Molecular pathogenesis of intrahepatic cholestasis of pregnancy. Expert Rev Mol Med. 2008;10:e9. doi: 10.1017/S1462399408000628.
3. Müllenbach R, Linton KJ, Wiltshire S, Weerasekera N, Chambers J, Elias E, Higgins CF, Johnston DG, McCarthy MI, Williamson C. ABCB4 gene sequence variation in women with intrahepatic cholestasis of pregnancy. J Med Genet. 2003;40(5):e70.
4. Sentilhes L, Bacq Y. Intrahepatic cholestasis of pregnancy. J Gynecol Obstet Biol Reprod (Paris). 2008;37(2):118-126. doi: 10.1016/j.jgyn.2006.09.007.
5. Reyes H, Simon FR. Intrahepatic cholestasis of pregnancy: an estrogen-related disease. Semin Liver Dis. 1993;13(3):289-301. doi: 10.1055/s-2007-1007357.
6. Gonzalez MC, Reyes H, Arrese M, Figueroa D, Lorca B, Andresen M, Segovia N, Molina C, Arce S. Intrahepatic cholestasis of pregnancy in twin pregnancies. J Hepatol. 1989;9(1):84-90.
7. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG. 2002;109(3):282-288.
8. Bacq Y, Sapey T, Bréchot MC, Pierre F, Fignon A, Dubois F. Intrahepatic cholestasis of pregnancy: a French prospective study. Hepatology. 1997;26(2):358-364.
9. Williamson C, Hems LM, Goulis DG, Walker I, Chambers J, Donaldson O, Swiet M, Johnston DG. Clinical outcome in a series of cases of obstetric cholestasis identified via a patient support group. BJOG. 2004;111(7):676-681. doi: 10.1111/j.1471-0528.2004.00167.x.
10. Geenes V, Chappell LC, Seed PT, Steer PJ, Knight M, Williamson C. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology. 2014;59(4):1482-1491. doi: 10.1002/hep.26617.
11. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology. 2004;40(2):467-474. doi: 10.1002/hep.20336.
12. Williamson C, Miragoli M, Sheikh Abdul Kadir S, Abu-Hayyeh S, Papacleovoulou G, Geenes V, Gorelik J. Bile acid signaling in fetal tissues: implications for intrahepatic cholestasis of pregnancy. Dig Dis. 2011;29(1):58-61. doi: 10.1159/000324130.
13. Sepúlveda WH, González C, Cruz MA, Rudolph MI. Vasoconstrictive effect of bile acids on isolated human placental chorionic veins. Eur J Obstet Gynecol Reprod Biol. 1991;42(3):211-215.
14. Geenes V, Chappell LC, Seed PT, Steer PJ, Knight M, Williamson C. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology. 2014;59(4):1482-1491. doi: 10.1002/hep.26617.
15. Wikström Shemer EA, Stephansson O, Thuresson M, Thorsell M, Ludvigsson JF, Marschall HU. Intrahepatic cholestasis of pregnancy and cancer, immune-mediated and cardiovascular diseases: A population-based cohort study. J Hepatol. 2015;63(2):456-461. doi: 10.1016/j.jhep.2015.03.010.
16. Obstetric Cholestasis, Green-top Guideline No.43. Available from: https://www.rcog.org.uk [Accessed 15th March 2017].
17. Bacq Y, Sentilhes L, Reyes HB, Glantz A, Kondrackiene J, Binder T, Nicastri PL, Locatelli A, Floreani A, Hernandez I, Di Martino V. Efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy: a meta-analysis. Gastroenterology. 2012;143(6):1492-1501. doi: 10.1053/j.gastro.2012.08.004.
18. Glantz A, Marschall HU, Lammert F, Mattsson LA. Intrahepatic cholestasis of pregnancy: a randomized controlled trial comparing dexamethasone and ursodeoxycholic acid. Hepatology. 2005;42(6):1399-1405. doi: 10.1002/hep.20952.
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