To study serum total bile acid levels during pregnancy

Abstract

Introduction: Intrahepatic cholestasis of pregnancy is a pregnancy-specific liver disorder characterized by maternal pruritus in the third trimester raised serum bile acids and increased rates of adverse fetal outcomes. Serum bile acid measurement is now considered to be the most suitable biochemical marker for both the diagnosis and monitoring of ICP. Bile acids have been repeatedly implicated in the etiology of the fetal disease, and the sensitivity of bile acids as a predictive marker of fetal risk has been examined in several studies involving small numbers of cases Materials and Methods: Some symptomatic patients with ICP and healthy pregnant women were included in the cross-sectional analysis. Results: Symptomatic women with ICP had higher total bile acid levels than healthy women (19.0 vs 4.4 P <.001). Total bile acid levesl were elevated in women with hepatitis virus, it means 20.4 ± 12.2 μmol / l (p <.001). 24 women with symptomatic of ICP had higher of Alkaline phosphatase test result, but it couldn’t be diagnostic criteria because during last trimester of pregnancy, Alkaline phosphotase is realizing from placenta. Conclusion: 1. In women who are presenting with cholestasis of pregnancy symptoms (n=36), average total serum bile acid was 19.0±9.2 µmol/l (p<.001) and in women who have viral hepatitis B, C, D and cholestasis (n=15), average TBA was 20.4±12.2 µmol/l (p<.001). These results are in line with “increased level” of international guidelines. Moreover, it shows that when symptoms or cholestasis are present, TBA increases on laboratory results. 2. In healthy women who are not presenting with cholestatic symptoms (n=37), average total bile acid level was 4.4±2.9 µmol/l (p<.001) which was in line with “normal” total bile acid. Furthermore, this result shows that it only increases during diseases. 3. The statistical significance of the total serum bile acid level of 2 groups of women who are either healthy or who have cholestatic symptoms are different. These results are in line with the levels indicated in the international diagnostic guidelines. Total bile acids are increased in the mothers who have viral hepatitis infection and cholestatic symptoms compared to the other group, which indicated that hepatitis virus may be a factor in increasing total bile acid.