title: [Treatment of obstetric cholestasis with polyunsaturated phosphatidylcholine and ursodeoxycholic acid].
abstract: OBJECTIVE
  Analysis of obstetric outcomes and laboratory results depending on blood serum level of bile acids (BA) in patients with obstetric cholestasis before treatment.
  
  
  METHODS
  The study was conducted among 43 pregnant women with obstetric cholestasis. The study population was divided into 3 groups, depending on blood serum level of bile acids before treatment: I group (n = 15)--BA 11-15 micromol/l, II group (n = 13)--BA 15-20 micromol/1 and III group (n = 15)--BA > 20 micromol/. Polyunsaturated phosphatidylcholine (PPC) treatment was used in I group, ursodeoxycholic acid (UDCA) in II group and combination of them in III group. Blood serum levels of transaminases, alkaline phosphatase and bilirubin were determined before treatment and during delivery Bile acids concentrations were also assessed during delivery in maternal serum and cord blood.
  
  
  RESULTS
  No significant statistical difference was observed in patients age, number of primiparas, delivery method, neonatal birth weight and Apgar score. The earliest obstetric cholestasis diagnosis was observed in III group. Earlier pregnancy termination, higher transaminases and bile acids levels before treatment, larger differences (A) of transaminases and bile acids levels before treatment and during delivery as well as larger A in bile acids levels before treatment and in cord blood during delivery were observed in III group in comparison to I group.
  
  
  CONCLUSIONS
  It seems that combined therapy with UDCA and PPC could be considered in obstetric cholestasis, especially in case of its early onset and/or severe course.
authors.affiliation: Katedra i Klinika Poloinictwa i Perinatologii Uniwersytetu Medycznego w Lublinie.
authors.forename: Beata
authors.initials: B
authors.lastname: Marciniak
authors.forename: Zaneta
authors.initials: Z
authors.lastname: Kimber-Trojnar
authors.forename: Bozena
authors.initials: B
authors.lastname: Leszczyńska-Gorzelak
authors.forename: Jolanta
authors.initials: J
authors.lastname: Patro-Małysza
authors.forename: Marcin
authors.initials: M
authors.lastname: Trojnar
authors.forename: Jan
authors.initials: J
authors.lastname: Oleszczuk
mesh_terms: D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood*; D002756:Cholagogues and Choleretics / Q000008:administration & dosage*; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011044:Poland; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods; D012436:S-Adenosylmethionine / Q000008:administration & dosage*; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D001647:Bile Acids and Salts; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D012436:S-Adenosylmethionine