SERUM BILE-ACIDS IN CHOLESTASIS OF PREGNANCY

  • 1 January 1977
    • journal article
    • research article
    • Vol. 50  (3) , 313-318
Abstract
Using routine liver function tests, cholestasis of pregnancy was diagnosed in 86 pregnant women with pruritus. Serum aminotransferase levels were elevated in all cases. ASAT [aspartate transaminase] in 99% and ALAT [alanine transaminase] in 100%. In these patients serum concentrations of cholic, chenodeoxycholic and deoxycholic acid were determined using a gas chromatographic method and were compared with those in a group of 40 uncomplicated pregnancies. Of these bile acids, cholic acid levels were most frequently elevated, i.e. in 92% of the patients. The frequency of elevation of serum levels of alkaline phosphatase, and total and conjugated bilirubin was lower. In addition to serum aminotransferase levels the serum cholic acid concentration is apparently a sensitive indicator of cholestasis of pregnancy. The cholestasis series was divided into 3 subgroups of increasing severity of cholestasis as assessed by maternal serum cholic acid levels, and the occurrence of signs of fetal distress was compared between these subgroups. The only intrauterine fetal loss in the series belonged to the severe cholestasis group. The incidence of meconium-stained amniotic fluid increased significantly in this group, and 21 of the 24 cases with other signs of fetal distress were in the groups of moderate all severe cholestasis.

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