Intrahepatic Cholestasis of Pregnancy: A Case Study of the Rare Onset in the First Trimester
| Autor: | Tamara Milovanovic, Djordje Culafic, Milica Ćulafić, Nina Pejic, Milos Stulic, Zeljko Vlaisavljevic, Violeta Culafic-Vojinovic, Goran Jankovic, Ivan Boricic, Milica Stojkovic Lalosevic |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Medicine (General) medicine.drug_class total serum bile acids Case Report Gastroenterology Liver disorder 03 medical and health sciences 0302 clinical medicine R5-920 Internal medicine Medicine Fetus Pregnancy 030219 obstetrics & reproductive medicine medicine.diagnostic_test Bile acid business.industry the first trimester General Medicine Jaundice pruritus medicine.disease 3. Good health First trimester 030220 oncology & carcinogenesis Liver biopsy medicine.symptom business Cholestasis of pregnancy intrahepatic cholestasis of pregnancy |
| Zdroj: | Medicina, Vol 55, Iss 8, p 454 (2019) Medicina |
| Popis: | Intrahepatic cholestasis of pregnancy (ICP) is a gestation-specific liver disorder, defined most often as the onset of pruritus, usually from the third trimester of pregnancy, associated with abnormal liver test results and/or increased total serum bile acids and spontaneous relief after delivery. The 21-year-old patient was admitted to our ward in the 11th week of pregnancy due to raised liver enzymes. The first onset of pruritus and jaundice appeared a month before hospitalization. Immunology tests and Toxoplasma gondii were negative. We excluded viral etiology, while alpha-1-antitrypsin, serum and urine copper levels, and thyroid hormones were within the reference values. The patient denied she had taken any medicines and herbal preparations before and during pregnancy. Total bile acids in the serum were significantly elevated (242 μmol/L). The abdominal ultrasound revealed a regular finding. Liver biopsy suggested a cholestatic liver disorder. After a presentation of all risks, the patient decided to stop the pregnancy. After a month, the hepatogram was within the reference values. Very rarely an ICP can occur in early pregnancy (first trimester), which calls for close monitoring. The risk of serious adverse fetal outcomes and spontaneous preterm delivery is proportional with increased levels of maternal serum bile acid. |
| Databáze: | OpenAIRE |
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