title: Intrahepatic cholestasis of pregnancy: correlation of preterm delivery with bile acids.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  Total bile acids are correlated with preterm delivery. An attempt to deliver at around 38 weeks may improve perinatal outcome.
authors.affiliation: Acıbadem University, Department of Obstetric and Gynecology, İstanbul, Turkey. ozpata@yahoo.com
authors.forename: Ozlem
authors.initials: O
authors.lastname: Pata
authors.forename: Eser
authors.initials: E
authors.lastname: Vardarelı
authors.forename: Alihan
authors.initials: A
authors.lastname: Ozcan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Serteser
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Unsal
authors.forename: Murat
authors.initials: M
authors.lastname: Saruç
authors.forename: Cihat
authors.initials: C
authors.lastname: Unlü
authors.forename: Nurdan
authors.initials: N
authors.lastname: Tözün
mesh_terms: D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D001647:Bile Acids and Salts / Q000097:blood*; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002780:Cholestasis, Intrahepatic / Q000097:blood* / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology*; D047928:Premature Birth / Q000097:blood* / Q000209:etiology; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D012621:Seasons; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001647:Bile Acids and Salts; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases