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. 2020 Dec;13(4):185-191.
doi: 10.1177/1753495X19868873. Epub 2019 Sep 2.

Detection of additional abnormalities or co-morbidities in women with suspected intrahepatic cholestasis of pregnancy

Frances Conti-Ramsden  1 , Michael McEwan  2 , Rachel Hill  1 , Julie Wade  1 , Georgina Abraham  1 , Olivia Buckeldee  2 , Catherine Williamson  1 , Caroline L Knight  1 , Joanna Girling  2 , Lucy C Chappell  1
Affiliations

Detection of additional abnormalities or co-morbidities in women with suspected intrahepatic cholestasis of pregnancy

Frances Conti-Ramsden et al. Obstet Med. 2020 Dec.

Abstract

Background: Current guidelines recommend viral, autoimmune, coagulation and liver ultrasound testing in intrahepatic cholestasis of pregnancy to exclude alternative diagnoses.

Methods: Electronic health records were searched for investigations and diagnoses in women with raised bile acid concentrations (>10 µmol/L) between January 2016 and December 2017 at two UK maternity units.

Results: Five hundred and thirty-one women had a raised bile acid concentration (median (IQR): 18 (13-32 µmol/L)) at a median gestation of 35.1 (IQR 31.8-37.0) weeks. Out of 531 women, 250 (47.1%) had full virology, autoimmune and ultrasound tests, and 348 (65.5%) had coagulation performed. Positive hepatitis B and C results were previously known. No new Epstein-Barr virus, cytomegalovirus or hepatitis A diagnoses were made. There were 11 positive autoimmune results, but no new diagnoses. No woman had an unexplained prolonged prothrombin time. No ultrasound liver (n = 38) or gallbladder (n = 85) abnormalities were of acute clinical significance.

Conclusion: Intrahepatic cholestasis of pregnancy investigations provided no new diagnoses that influenced clinical management during pregnancy.

Keywords: Cholestasis; pregnancy.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram illustrating the selection of women with raised bile acid concentrations in pregnancy. BA: bile acid.
See this image and copyright information in PMC

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