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Predicting fetal asphyxia in intrahepatic cholestasis of pregnancy

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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Intrahepatic cholestasis of pregnancy (ICP) is a disease associated with high-perinatal morbidity and mortality rates. It is important to have parameters that aid in predicting fetal outcomes. Certain parameters affecting asphyxia in newborns to mothers with ICP are evaluated in this study.

Methods

One hundred eighty-seven cholestatic pregnancies were analyzed, retrospectively. Fetal asphyxia was defined as an APGAR score of less than 7 at 5 min postpartum. Predictors of asphyxia in ICP were analyzed by binary multivariate logistic regression analysis.

Results

Thirty-six of the cholestatic pregnancies ended up having an asphyctic newborn at the time of delivery (19.2%). There was a statistically significance difference in the levels of total bile acids (TBA) (42.4 ± 15.2 vs. 33.8 ± 12.9 μmol/L, P < 0.01), HDL cholesterol (54.2 ± 15.9 vs. 61.3 ± 12.2, P = 0.01), total cholesterol (279.0 ± 51.4 vs. 257.7 ± 51.6, P = 0.02), and triacylglycerol (299.4 ± 94.6 vs. 260.4 ± 118.7) between the asphytic and nonasphytic group. Binary multivariate logistic regression analysis demonstrated that TBA levels (OR 1.04, 95% CI 1.01–1.08, P = 0.03) and exposure time (OR 1.11, 95% CI 1.05–1.17, P < 0.01) were the most important independent variables predicting fetal asphyxia in ICP.

Conclusions

In this study, it has been demonstrated that for the evaluation of fetal status, increased TBA levels in the mother and increased exposure time for the fetus to these increased values of TBA within the maternal circulation system help to predict increased risk of asphyxia in newborns to ICP mothers.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Agean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey

    Deniz Oztekin & Sivekar Tinar

  2. Department of Gyneacology and Obstetrics, Kocaman Hospital, Izmir, Turkey

    Ipek Aydal

  3. Department of Radiology, Bozyaka Training and Research Hospital, Izmir, Turkey

    Ozgur Oztekin

  4. Department of Pediatrics, Agean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey

    Sabriye Okcu

  5. Department of Biochemistry, Agean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey

    Rengin Borekci

  6. Albayrak mavisehir evleri, Yali mahallesi, 6525 sok. no: 35 daire no: 31 Karsiyaka, Izmir, Turkey

    Deniz Oztekin

Authors
  1. Deniz Oztekin
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  2. Ipek Aydal
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  3. Ozgur Oztekin
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Correspondence to Deniz Oztekin.

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Oztekin, D., Aydal, I., Oztekin, O. et al. Predicting fetal asphyxia in intrahepatic cholestasis of pregnancy. Arch Gynecol Obstet 280, 975–979 (2009). https://doi.org/10.1007/s00404-009-1052-x

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  • DOI: https://doi.org/10.1007/s00404-009-1052-x

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