title: The impact of intrahepatic cholestasis of pregnancy on fetal cardiac and peripheral circulation.
abstract: OBJECTIVE
  The aim of this study was to evaluate changes in fetal cardiac and peripheral circulation in pregnancies complicated with intrahepatic cholestasis.
  
  
  METHODS
  The Doppler examination results of 22 pregnant subjects complicated with intrahepatic cholestasis of pregnancy (ICP) and 44 healthy controls were compared. The parameters of fetal cardiac circulation were pulmonary artery and aortic (Ao) peak systolic velocity (PSV), pulmonary vein (Pv), peak velocity index (PVI) and pulsatility index (PI), mitral valve (MV) and tricuspid valve (TV), early diastole (E)- and atrial contraction (A)-wave peak velocity ratio (E/A), and isthmus aortic peak systolic velocity (IAo PSV). The parameters of fetal peripheral circulation were middle cerebral artery (MCA) and umbilical artery (UA) PI, resistance index (RI), systolic/diastolic (S/D) ratio. Fetal obstetric Doppler monitoring was conducted weekly before 36 weeks and biweekly after that, and the results were compared with the normal reference values for gestational age.
  
  
  RESULTS
  The Doppler parameters of fetal cardiac and peripheral circulation did not significantly differ between the two groups. S/D ratio readings in the ICP group were significantly above 2 SD before 35 weeks of gestation. Women with ICP had increased risks of preterm delivery, neonatal unit admission, and meconium-stained amniotic fluid compared with those in the controls.
  
  
  CONCLUSIONS
  Fetuses of pregnant women with ICP showed no differences in the evaluation of cardiac and peripheral Doppler measurements compared with fetuses of healthy mothers. The Doppler investigation of the umbilical artery may be useful in monitoring of pregnancies complicated by early onset intrahepatic cholestasis.
authors.affiliation: Department of Obstetrics and Gynecology, Kâtip Çelebi University Faculty of Medicine, İzmir, Turkey.
authors.forename: Seçil
authors.initials: S
authors.lastname: Kurtulmuş
authors.affiliation: Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey.
authors.forename: Esra Bahar
authors.initials: EB
authors.lastname: Gür
authors.affiliation: Department of Obstetrics and Gynecology, Aegean Maternity and Teaching Hospital, İzmir, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Öztekin
authors.affiliation: Department of Obstetrics and Gynecology, Aegean Maternity and Teaching Hospital, İzmir, Turkey.
authors.forename: Ebru Şahin
authors.initials: EŞ
authors.lastname: Güleç
authors.affiliation: Department of Obstetrics and Gynecology, Aegean Maternity and Teaching Hospital, İzmir, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Okyay
authors.affiliation: Department of Obstetrics and Gynecology, Aegean Maternity and Teaching Hospital, İzmir, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Gülhan
keywords: Intrahepatic cholestasis of pregnancy; fetal Doppler; fetal cardiac circulation