Preeclampsia with abnormal liver function tests is associated with cholestasis in a subgroup of cases.
OBJECTIVE
To investigate whether women with preeclampsia and abnormal liver function tests have raised serum bile acids.


METHODS
Measurement of serum bile acids in serum specimens collected at the John Radcliffe Hospital, Oxford.


METHODS
Imperial College School of Medicine.


METHODS
Stored sera from 37 women with preeclampsia and abnormal liver function tests and from 19 controls.


METHODS
Enzymic total bile acid assay.


METHODS
Total bile acid levels.


RESULTS
Women with preeclampsia and abnormal liver function tests had higher median bile acid levels than controls (5.7 vs. 3.2, p = 0.01). The reason for the raised median serum bile acid levels in the patient group is that three (8%) women with preeclampsia had markedly raised serum bile acids levels. There were no obvious clinical or biochemical features specific to these patients.


CONCLUSIONS
The pathological mechanisms causing hepatic impairment in some women with preeclampsia may predispose to cholestasis. As some women with preeclampsia and abnormal liver function complain of pruritus, we recommend checking the serum bile acids in this group of women. If these acids are raised the fetal prognosis may be adversely affected.
Goulis
Dimitrios G
DG
Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, London, UK.
Walker
Ian A L
IA
de Swiet
Michael
M
Redman
Christopher W G
CW
Williamson
Catherine
C
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002779:Cholestasis / Q000150:complications* / Q000188:drug therapy; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008429:Maternal Welfare; D008750:Methyldopa / Q000627:therapeutic use; D009543:Nifedipine / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D016896:Treatment Outcome; D006113:United Kingdom
D000316:Adrenergic alpha-Agonists; D000893:Anti-Inflammatory Agents; D001647:Bile Acids and Salts; D015415:Biomarkers; D002121:Calcium Channel Blockers; D008750:Methyldopa; D003907:Dexamethasone; D009543:Nifedipine