Molecular pathogenesis of intrahepatic cholestasis of pregnancy

@article{Arrese2008MolecularPO,
  title={Molecular pathogenesis of intrahepatic cholestasis of pregnancy},
  author={Marco Arrese and Rocio I. R. Macias and Oscar Briz and Mar{\'i}a Julia P{\'e}rez and Jose J. G. Marin},
  journal={Expert Reviews in Molecular Medicine},
  year={2008},
  volume={10}
}
Intrahepatic cholestasis of pregnancy (ICP) occurs mainly in the third trimester and is characterised by pruritus and elevated serum bile acid levels. ICP is associated with an increased perinatal risk and higher rates of foetal morbidity and mortality. Although the pathogenesis of this disease is unknown, a genetic hypersensitivity to female hormones (oestrogen and/or progesterone) or their metabolites is thought to impair bile secretory function. Recent data suggest that mutations or… 

Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

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  • 2015
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and

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Cholestasis of pregnancy is a dysfunction of the liver characterized by pruritus and increased concentration of bile acids in the plasma during the second and third trimester, which increases the risk of spontaneous preterm birth, meconium stained amniotic fluid, fetal distress, and intrauterine fetal death.

Intrahepatic Cholestasis Of Pregnancy - A Review

Intrahepatic cholestasis of pregnancy (ICP) is a complex disease described by pruritus connected with elevated serum bile acid or amino transferase level, and Ursodeoxycholicacid (dose) is the treatment of choice for ICP.

Two cases of first onset intrahepatic cholestasis of pregnancy associated with moderate ovarian hyperstimulation syndrome after IVF treatment and review of the literature

  • M. MutluK. Aslan A. Erdem
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2017
Two cases of pregnancy after IVF treatment diagnosed with ICP are presented following the development of OHSS, deteriorating liver function tests and severe pruritus.

Management of Intrahepatıc Cholestasıs of Pregnancy : Revıew of Lıterature

The epidemiology, clinical features, etiology, diagnosis, pharmacologic treatment and obstetric management of intrahepatic cholestasis of pregnancy are reviewed.

Unfolding newer concepts in placental pathology of obstetric cholestasis-a cause for prematurity.

This review attempts to highlight the recent understanding of the mechanisms that operate in the placenta in patients with obstetric cholestasis that lead to poor fetal outcomes, through various studies published in the literature.

Intrahepatic Cholestasis of Pregnancy: A Review of Diagnosis and Management.

Providers should be aware of the signs and symptoms of ICP and provide accurate diagnosis and management of affected women and women with a diagnosis of I CP should be treated with ursodeoxycholic acid to improve maternal symptoms.

Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) appears in the second and third trimester of pregnancy and is characterized by pruritus and an increase of serum bile acid concentration. Cholestasis is
...

References

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Current evidence proposes susceptibility to derangements in the sulfation of steroid compounds, affecting the metabolism of progesterone and bile acids in the fetal/placental compartment, causing intrahepatic cholestasis of pregnancy.

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Ursodeoxycholic acid (UDCA) administration provides a significant improvement in maternal pruritus and in the biochemical abnormalities, with no adverse effects in the mother or child.

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Future clinical and experimental studies should provide better insight into the pathogenesis of cholestasis, the mechanisms of bile formation and secretion, and the metabolism of estrogens and other sex hormones and their alteration relationship to cholESTasis, a disorder that is highly prevalent in humans.

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The hydrophilic bile acid ursodeoxycholic acid (10–20 mg/kg/d) is today regarded as the first line treatment for intrahepatic cholestasis of pregnancy.

Intrahepatic Cholestasis of Pregnancy: An Intriguing Pregnancy-Specific Disorder

Recent data suggest that oral use of ursodeoxycholic acid improves maternal condition and might prevent the fetal complications of ICP, and careful fetal assessment and appropriate medical intervention might improve perinatal outcome.

Intrahepatic cholestasis of pregnancy: from bedside to bench to bedside

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Data obtained in the last 3 years support an involvement of MDR3 (ABCB4) genetic variation in the pathogenesis of ICP, especially in patients with cholelithiasis or elevated serum GGT activity.

Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates

No increase in fetal risk was detected in ICP patients with bile acid levels < 40 μmol/L, and it is proposed that these women be managed expectantly, which would significantly reduce the costs of medical care.

Relationship between asymptomatic hypercholanaemia of pregnancy and progesterone metabolism.

The results suggest that AHP is a relatively common condition in the authors' geographical location, where ICP is rarely diagnosed, and the simultaneous finding of lower serum total progesterone levels along with an increase in its metabolites supports the hypothesis that a primary defect in progestersone metabolism may be involved in the aetiology of ICP.
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