title: Acidosis: A potential explanation for adverse fetal outcome in intrahepatic cholestasis of pregnancy. A case report.
abstract: BACKGROUND
  Intrahepatic cholestasis of pregnancy is a cholestatic disorder with an increased risk for adverse perinatal outcome. The mechanism underlying intrauterine demise is poorly understood.
  
  
  METHODS
  A nulliparous woman with gestational age of 36 plus 6 weeks presented with suspected intrahepatic cholestasis. Continuous CTG monitoring evolved from a normal pattern towards a non-reassuring pattern. A male neonate was delivered by caesarean section. Apgar scores 0, 1 and 4 at 1, 5 and 10 min. Fetal cord gas analysis showed pH 6.98, base deficit -15 mmol/L. Blood results showed maternal serum bile acid concentration of 220 µmol/L.
  
  
  CONCLUSIONS
  Our case suggests gradual evolution towards hypoxia and acidosis. It is unknown whether certain components in the bile acid concentrations might contribute to a fetal metabolic component of the acidosis.
authors: Department of Obstetrics and Gynaecology, University Medical Centre Erasmus, Rotterdam, the Netherlands.
authors: K
authors: K
authors: Sterrenburg
authors: Department of Obstetrics and Gynaecology, Internal Medicine, University Medical Centre Erasmus, Rotterdam, the Netherlands.
authors: W
authors: W
authors: Visser
authors: Department of Pediatrics, Division of Neonatology, University Medical Centre Erasmus, Rotterdam, the Netherlands; Department of Neurology, Division of Pediatric Neurology, University Medical Centre Erasmus, Rotterdam, the Netherlands.
authors: L S
authors: LS
authors: Smit
authors: Department of Obstetrics and Gynaecology, University Medical Centre Erasmus, Rotterdam, the Netherlands.
authors: J
authors: J
authors: Cornette
keywords: High-risk pregnancy; complications