Gall bladder functional changes and maternal serum bile acids in pruritis of pregnancy

ABSTRACT

Ultrasonographic measurement of the gallbladder volume was taken in 26 women with third-trimester normal pregnancies and in 28 third trimester pregnant women complaining of pruritis of pregnancy. Ultrasonic examinations were performed in the fasting state and 10, 20, 30, 45 and 60 minutes after ingestion of fatty meal. The total and direct bilirubin were assayed, and the fasting and two hours postprandial maternal serum bile acid [Cholyglycin] was estimated for all studied women. Gravidas with pruritis had significantly increased mean resting gallbladder volume [P<0.02] and ejection fraction [P<0.01] as compared to those means of control normal gravidas. The emptying time and residual volume showed non significant difference in the studied groups. Serum total and direct bilirubin levels were normal in the studied groups. There was significant increase in postprandial material serum bile acid [Cholyglycin] in gravidas with pruritis, as compared to their fasting mean [P<0.005] and to the postprandial mean of control normal gravidas [P<0.005]. The results indicated that in gravidas with pruritis, the gallbladder function and the enterohepatic circulation of bile acids were different from normal pregnancies. A new explanation for increased maternal serum bite acids is proposed