The rate of fetal complications increases when maternal serum bile acid levels become elevated in women who develop intrahepatic cholestasis of pregnancy, reported Dr. Anna Glantz of Sahlgrenska University Hospital/East, Goteborg, Sweden, and her colleagues.
Intrahepatic cholestasis of pregnancy (ICP), defined as pruritus in pregnancy plus 10 [micro]mol/L or more of serum bile acids, occurred in 1.5% of 45,485 pregnancies recorded in a region of Sweden in February 1999-January 2002. The probability of the fetal complications of spontaneous preterm deliveries, asphyxial events, and meconium staining of amniotic fluid, placenta, and membranes rose by 1%-2% for each additional [micro]mol/L of maternal serum bile acid when the total level of bile acids exceeded 40 [micro]mol/L.
Most of the women with ICP (81%) had serum bile acid levels between 10 and 39 [micro]mol/L, while the other 19% had serum bile acid levels of at least 40 [micro]mol/L.
"Pregnant women with pruritus should be surveilled with repeated determinations of serum bile acids" with expectant management when the bile acid level is below 40 [micro]mol/L and control of symptoms with [H.sub.1]-receptor blockers or ursodeoxycholic acid, the investigators suggested (Hepatology 40[2]:467-74, 2004).
COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group
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