Euroasian journal of hepato-gastroenterology

Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization

Filiz F Bolukbas, Cengiz Bolukbas, Hatice Y Balaban, Cem Aygun, Seyda Ignak, Emine Ergul, Mehtap Yazicioglu, Suat S Ersahin

Citation Information : Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepatogastroenterol 2017; 7 (2):126-129.

DOI: 10.5005/jp-journals-10018-1232

License: CC BY 3.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/spontaneous pregnancy.

Materials and methods

We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.

Results

We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = −0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.

Conclusion

Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP.

How to cite this article

Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.


HTML PDF Share
  1. The course of pregnancy and delivery and the use of maternal healthcare services after standard IVF in Northern Finland 1990-1995. Hum Reprod 2002 Nov;17(11):2897-2903.
  2. Pregnancy outcome with intrahepatic cholestasis. Obstet Gynecol 1999 Aug;94(2):189-193.
  3. Intrahepatic cholestasis of pregnancy. Clin Liver Dis 2004 Feb;8(1):167-176.
  4. Intrahepatic cholestasis of pregnancy. Obstet Gynecol 2014 Jul;124(1):120-133.
  5. Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy. Am J Obstet Gynecol 2014 Sep;211(3):189-196.
  6. Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy. Am J Obstet Gynecol 2015 Oct;213(4):570.e1-578.e1.
  7. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology 2004 Aug;40(2):467-474.
  8. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy. Am J Perinatol 2008 Jun;25(6):341-345.
  9. Intrahepatic cholestasis of pregnancy: correlation of preterm delivery with bile acids. Turk J Gastroenterol 2011 Dec;22(6):602-605.
  10. Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes: a 12-year population-based cohort study. BJOG 2013 May;120(6):717-723.
  11. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000 Dec;33(6):1012-1021.
  12. Role of bile acid measurement in pregnancy. Ann Clin Biochem 2002 Mar;39(Pt 2):105-113.
  13. Serum bile acids in the early diagnosis of intrahepatic cholestasis of pregnancy. Obstet Gynecol 1983 May;61:581-587.
  14. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG 2002 Mar;109(3):282-288.
  15. Fetal mortality associated with cholestasis of pregnancy and the potential benefit of therapy with ursodeoxycholic acid. Gut 1995 Oct;37(4):580-584.
  16. Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome. Am J Obstet Gynecol 1994 Mar;170(3):890-895.
  17. Fetal death in a patient with intrahepatic cholestasis of pregnancy. Obstet Gynecol 2006 Feb;107(2 Pt 2):458-460.
  18. Clinical outcome in a series of cases of obstetric cholestasis identified via a patient support group. BJOG 2004 Jul;111(7):676-681.
  19. Obstetric cholestasis: outcome with active management. Eur J Obstet Gynecol Reprod Biol 2002 Jan;100(2):167-170.
  20. Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial. BMJ 2012 Jun;344:e3799.
  21. Interventions for treating cholestasis in pregnancy. Cochrane Database Syst Rev 2013 Jun;6:CD000493.
  22. Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy: a randomized controlled trial. Arch Gynecol Obstet 2014 Mar;289(3):541-547.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.