Some biochemical indices in cholestasis of pregnancy

ABSTRACT

This study Includes 29 pregnant women at their 36-39 weeks of pregnancy, 14 of them were suffering from itching of unknown cause and diagnosed as [cholestatic group] by the obstetrician and the physician, the other 15 were apparently healthy normal pregnant women and considered to be [control group]. Serum alanine aminotransferase [ALT], Aspartate aminotransferase [AST], Alkaline phosphatase [AP], Garnma-glutamy1 transferse [gamma gT], Cholic acid [CA], Chenodeoxy cholic acid [CDCA], prolactin and specific beta glycoprotein [Sp1] were estimated in the two studied groups. The results obtained showed that ALT, AST, CA and CDCA were significantly increased, on the otherhand Sp1 was significantly decreased, while AP, gamma gT and prolactin showed nonsignificant changes. In the cholestatic group compared to the normal control group. In the cholestatic group ALT, AST, AP and gamma gT were over the mean values of the control group in 71.4, 57.1, 25.7 and 42.9% of cases respectively, while CA and CDCA in 85.7 and 71.4% of cases respectively. Thus it appears that serum CA is a sensitive indicator of cholestasis in pregnancy. Fetal and maternal morbidity demonstrated in the 14 cholestatic pregnant women were; premature deliveries in 2 cases, postpartum haemorrhage in 4 cases, meconium stained amniotic ftuid in 6 cases, low birth weight in 3 cases and bad Apgarscore at 5 minutes in 2 cases. It is concluded that consideration should be given to the measurement of serum bile acids particularly [CA] in all pregnant women with unexplained pruritus. Those with high levels should be subjected to a more intensive follow up