Evaluation of perinatal outcomes according to fasting bile acie level in pregnant women diagnosed with intrahepatic cholestasis.

Objective: This study aimed to determine perinatal outcomes based on fasting bile acid concentrations in pregnant women diagnosed with intrahepatic cholestasis of pregnancy (ICP) and to assess pregnancy management according to fasting bile acid levels. Methods: This study is carried out with 160 patients who were diagnosed with Intrahepatic Cholestasis of Pregnancy and gave birth in the same clinic. The patients were divided into two groups based on their fasting bile acid concentrations: Group 1 (54 patients), with levels between 10 and 40 micromol/liter, defining mild ICP according to the literature, and Group 2 (106 patients), with levels above 40 micromol/liter, defining severe ICP. The birth weeks, delivery methods, indications for cesarean section if applicable, birth weights, 1st and 5th minute APGAR scores, neonatal intensive care unit admission, presence of meconium-stained amniotic fluid at birth, and fetal death data of both groups were recorded and compared. Results: Patients with severe ICP were found to have statistically higher ALT and total bilirubin values than patients with mild ICP. (p<0.001, p<0.001 respectively). The presence of meconium was significantly higher in group 2 patients compared to patients group 1 patients (26.4% and 9.3%, respectively; p=0.011). It was found that the weeks of diagnosis of cholestasis and weeks of labor were significantly greater in the patients with meconium in the amniotic fluid compared to the group without meconium (34,9±3,4; 33,0±3,5; p=0,002 ve 38,1±0,9; 36,9±1,5 respectively; p<0,001). Group 2 patients were found to have significantly higher incidence rates of ALT values above 75 and AST values above 130 compared to group 1 patients (p<0,001). Conclusion: Intrahepatic cholestasis of pregnancy causes unpredictable fetal complications. The patients with values of bile acid above 40 and ALT values above 75 and/or having meconium stained amniotic fluid during labor should evaluated carefully due to the association with poor perinatal outcomes. [ABSTRACT FROM AUTHOR]