Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids

ÜNSAL, İbrahim; VARDARELİ, Eser; Tozun, Ayse Nurdan; ÖZCAN, Alihan; Ünlü, Mehmet Cihat; PATA, OZLEM; Saruç, Murat; Serteser, Mustafa

Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids

Özlem PATA, (Acıbadem Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Eser VARDARELİ, (Acıbadem Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, İstanbul, Türkiye)

Alihan ÖZCAN, (Acıbadem Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Mustafa SERTESER, (Acıbadem Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, İstanbul, Türkiye)

İbrahim ÜNSAL, (Acıbadem Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, İstanbul, Türkiye)

Murat SARUÇ, (Acıbadem Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, İstanbul, Türkiye)

Cihat ÜNLÜ, (Acıbadem Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul, Türkiye)

Nurdan TÖZÜN (Acıbadem Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, İstanbul, Türkiye)

Turkish Journal of Gastroenterology

2 0

Yıl: 2011 Cilt: 22 Sayı: 6 Sayfa Aralığı: 602 - 605 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids

Öz:

Amaç: Bu çalışmada, gebelikte gözlenen intrahepatik kolestaz olgularının insidansı, obstetrik ve fetal komplikasyonlarının tanımlanması ve ortaya konulan sonuçların karaciğer fonksiyon testleri ve safra asitleri ile korelasyonunun değerlendirilmesi amaçlandı. Yöntem: Kliniğimizde antenatal takibi yapılan ve doğumu gerçekleştirilen 3710 olgunun 32’sinde gebeliğin intrahepatik kolestazı tanısı konuldu. Olguların obstetrik-medikal hikâyeleri, laboratuvar sonuçları, belirtilerin başlama tarihi, kaşıntı dereceleri, tedaviye cevapları, doğum zamanlamaları, yenidoğan bebeklerin bilgileri çalışma protokolüne alındı. ‹statistiki analizler SPSS 12.0 versiyon kullanılarak yapıldı. Korelasyonun ortaya konulmasında Spearman Rank Korelasyon Analizi kullanıldı. Bulgular: ‹ntrahepatik kolestaz olgularının insidansı %0.86 olarak bulundu. Semptomlar 32. hafta civarında gözlendi. Multipar olguların %16,6’sında daha önceki gebelikte, gebeliğin intrahepatik kolestazının gözlendiği, tüm olguların ise %21,8’inde aile öyküsünün olduğ u saptandı. Semptomların gözlenme zamanının mevsimlere göre değiştiği ve bunun istatistiki olarak anlamlı olduğu gözlendi (p<0.05). Olgularının büyük çoğunluğunun (%69.5) kış aylarında veya ilkbahar başlarında gözlendiği ortaya konuldu. Hiçbir olguda klinik olarak sarılık, kanamaya meyil veya fetal ölüm gözlenmedi. Ursadeoksikolik asit ile kaşıntı şiddeti azaldı. Erken do- ğum gözlenen olgularda ise serum safra asitlerinin daha yüksek olduğu ortaya konuldu (r=0.409, p=0.038). Sonuç: Total safra asitleri erken doğum ile koreledir. 38. haftalarda doğum planlaması ile perinatal outcome iyileştirilebilir.

Anahtar Kelime:

Konular: Cerrahi

Gebeliğin intrahepatik kolestazı: Safra asitleri ile preterm doğumun korelasyonu

Öz:

Background/aims: The aim of this study was to determine the incidence, obstetrical and fetal complication rates of intrahepatic cholestasis of pregnancy in patients managed actively around 38 weeks and evaluate the correlation of these results with liver function tests and bile acids. Material and Methods: In this cohort study 3710 women were booked for delivery, of which 32 pregnant women were diagnosed as intrahepatic cholestasis of pregnancy. All data concerning obstetric- medical history, laboratory results, symptom onset time, pruritus degree, treatment response, and delivery time and infants information were recorded in the study protocol. Statistical analyses were conducted with SPSS 12.0 version and correlations were assessed by Spearman Rank correlation analysis. Results: The incidence of intrahepatic cholestasis of pregnancy was 0.86%. The symptoms appeared around 32 weeks. 16.6% multiparas had a previously affected pregnancy and 21.8% of intrahepatic cholestasis of pregnancy patients had family history of intrahepatic cholestasis of pregnancy. Symptom onset varied according to season (p<0.05). Most patients (69.5%) were diagnosed in winter and the beginning of spring. There were no reported cases of clinical maternal jaundice, bleeding tendency or stillbirth. Pruritus was decreased by ursodeoxycholic acid treatment. Total bile acids tended to be higher in patients with preterm delivery (r=0.409, p=0.038). Conclusion: Total bile acids are correlated with preterm delivery. An attempt to deliver at around 38 weeks may improve perinatal outcome.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	PATA O, VARDARELİ E, ÖZCAN A, Serteser M, ÜNSAL İ, Saruç M, Ünlü M, Tozun A (2011). Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. , 602 - 605.
Chicago	PATA OZLEM,VARDARELİ Eser,ÖZCAN Alihan,Serteser Mustafa,ÜNSAL İbrahim,Saruç Murat,Ünlü Mehmet Cihat,Tozun Ayse Nurdan Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. (2011): 602 - 605.
MLA	PATA OZLEM,VARDARELİ Eser,ÖZCAN Alihan,Serteser Mustafa,ÜNSAL İbrahim,Saruç Murat,Ünlü Mehmet Cihat,Tozun Ayse Nurdan Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. , 2011, ss.602 - 605.
AMA	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. . 2011; 602 - 605.
Vancouver	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. . 2011; 602 - 605.
IEEE	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A "Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids." , ss.602 - 605, 2011.
ISNAD	PATA, OZLEM vd. "Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids". (2011), 602-605.

APA	PATA O, VARDARELİ E, ÖZCAN A, Serteser M, ÜNSAL İ, Saruç M, Ünlü M, Tozun A (2011). Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. Turkish Journal of Gastroenterology, 22(6), 602 - 605.
Chicago	PATA OZLEM,VARDARELİ Eser,ÖZCAN Alihan,Serteser Mustafa,ÜNSAL İbrahim,Saruç Murat,Ünlü Mehmet Cihat,Tozun Ayse Nurdan Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. Turkish Journal of Gastroenterology 22, no.6 (2011): 602 - 605.
MLA	PATA OZLEM,VARDARELİ Eser,ÖZCAN Alihan,Serteser Mustafa,ÜNSAL İbrahim,Saruç Murat,Ünlü Mehmet Cihat,Tozun Ayse Nurdan Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. Turkish Journal of Gastroenterology, vol.22, no.6, 2011, ss.602 - 605.
AMA	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. Turkish Journal of Gastroenterology. 2011; 22(6): 602 - 605.
Vancouver	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids. Turkish Journal of Gastroenterology. 2011; 22(6): 602 - 605.
IEEE	PATA O,VARDARELİ E,ÖZCAN A,Serteser M,ÜNSAL İ,Saruç M,Ünlü M,Tozun A "Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids." Turkish Journal of Gastroenterology, 22, ss.602 - 605, 2011.
ISNAD	PATA, OZLEM vd. "Intrahepatic cholestasis of pregnancy: Correlation of preterm delivery with bile acids". Turkish Journal of Gastroenterology 22/6 (2011), 602-605.