Alanine aminotransferase as a predictor of adverse perinatal outcomes in women with intrahepatic cholestasis of pregnancy

Objective: To evaluate the associations between adverse perinatal outcomes and serum transaminase levels at the time of diagnosis in patients with intrahepatic cholestasis of pregnancy

Methods: We performed a retrospective analysis of patients hospitalized for evaluation of intrahepatic cholestasis of pregnancy from January 2013 to June 2014 in a tertiary center. Seventy-one patients were divided into two groups according to the presence [Group I] or absence of adverse perinatal outcomes [Group II]

Results: The mean aminotransferase levels and conjugated bilirubin levels at the time of diagnosis were significantly higher in Group I than in Group II. Receiver operating characteristic curve analysis revealed that the alanine aminotransferase level could predict adverse perinatal outcomes with 76.47% sensitivity and 78.38% specificity, and the cut-off value was 95 IU/L.Among patients with intrahepatic cholestasis of pregnancy, those with adverse perinatal outcomes were significantly older, had an earlier diagnosis, and had higher alanine aminotransferase levels. Using the 95-IU/L cut-off value, patients with intrahepatic cholestasis of pregnancy had a 3.54-fold increased risk for adverse perinatal outcomes

Conclusions: Patients with intrahepatic cholestasis of pregnancy and high alanineaminotransferase levels should be followed up for possible adverse perinatal outcomes

Contraceptive failure with Copper T380A intrauterine device [IUD]: a single tertiary center experience

Objective: The objective of this study was to assess the risk factors of pregnancy with Copper [Cu]T380A IUD and pregnancy outcomes

Methods:A retrospective study evaluating the risk factors and pregnancy outcomes of 81 patients who conceived with CuT380A IUD in situ

Results:Four ectopic pregnancies and 77 intrauterine pregnancies were detected. Twenty-six pregnancies [33.76%, 26/77] were terminated according to maternal desire. Twenty-five patients [32.46%, 25/77] whose IUDs were removed constituted the Removed IUD Group, and the remaining 26 patients constituted IUD Left in situ Group. Term pregnancy rates [76% vs. 20.8%, p=0.002] were significantly higher in the Removed IUD Group compared with the IUD Left in situ Group. Abortion rates [16% vs. 53.84%, p=0.008] were detected significantly higher in the IUD Left in situ Group

Conclusion:The main result of our study was that pregnancy with CuT380A in situ is a significant risk factor for adverse perinatal outcome. Adjusting the scheduled follow-ups for checking the IUD seems to be important in order to prevent accidental pregnancy