Research Article
Gebeliğin İntrahepatik Kolestazıyla Antenatal Aneuploidi Serum Tarama Markerları Arasında İlişki Var mı?
Abstract
Giriş
Bu çalışmanın amacı antenatal dönemde yapılan serum tarama testlerindeki biokimyasal markerlerin gebeliğin intrahepatik kolestazını öngörebilme özelliğinin araştırılmasıdır.
Materyal ve Method
Bu vaka - kontrol gruplu çalışmada retrospektif olarak hasta kayıtları değerlendirilmiştir. Çalışmaya 156 gebe kadın dahil edilmiştir ( Çalışma , 49 kolestaz tanısı alan gebe ve 116 kontrol grubu gebelerden oluşmaktadır ).
Sonuçlar
İkinci trimesterde taranan alfa -fetoprotein (AFP) MoM , unkonjuge estriol (E3) MoM ve total B-HCG MoM değerleri, her 2 grupta benzerdi (p=0.299 , p=0.571, p=0.285). Birinci trimester tarama testi parametresi olan PAPP-A MoM değerine bakıldığında , kolestaz tanısı almış grup ile kontrol grubu arasında fark saptanmamıştır (p=0.103).
Tartışma
Sonuç olarak çalışmamızda birinci ve ikinci trimesterdeki prenatal serum tarama testlerinde bakılan biokimyasal markerler intrahepatik kolestazı öngörmede yetersiz kalmıştır. Çalışmamızın retrospektif olması ve hasta populasyonunun az olması bunun nedenleri arasındadır. Daha anlamlı sonuçlar için hasta populasyonunun fazla olduğu prospektif bir çalışma yapılması gerektiği kanısındayız .
Keywords
References
- 1.Williamson C, Geenes V. intrahepatic cholestasis of pregnancy .Obstet. Gynecol 2014;124:120-33.
- 2. Joshi D, James A, Quaglia A, Alberto Quaglia, Rachel H Westbrook, Michael A Heneghan.Liver disease in pregnancy. Lancet 2010;375:594-605
- 3. Arrese M, Reyes H, Intrahepatic cholestasis of pregnancy : a past and present riddle .Ann Hepatol 2006;5:202-5
- 4. Fisk NM, Bye W B ,Storey GN. Fetal outcome in obstetric cholestasis. BrJ Obstet Gynaecol 1988;95:1137–43.
- 5. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology 2004;40:467–74. 6. Laatikainen T, Ikonen E. Fetal prognosis in obstetric hepatosis. Ann Chir Gynaecol Fenn 1975;64:155–64.
- 7. Laatikainen T, Tulenheimo A. Maternal serum bile acid levels and fetal distress in cholestasis of pregnancy. Int J Gynaecol Obstet 1984;22:91–4.
- 8. Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines. Eur J Obstet Gynecol Reprod Biol. 2018;231:180–187. doi:10.1016/j.ejogrb.2018.10.041
- 9.Dixon PH, Williamson CJC, Clin Res Hepatology Gastroenterology.
- The pathophysiology of intrahepatic cholestasis of pregnancy. 2016 Apr;40(2):141-53. doi: 10.1016/j.clinre.2015.12.008.
- 10. Kang JH, Farina A, Park JH, et al. Down syndrome biochemical markers and screening for preeclampsia at first and second trimester: correlation with the week of onset and the severity. Prenat Diagn 2008; 28: 704-9.
- 11. Gutaj P, Wender-Ożegowska E, Brązert J. Maternal lipids associated with large-for-gestational-age birth weight in women with type 1 diabetes: results from a prospective single-center study. Arch Med Sci 2017; 13: 753-9.
- 12. Goetzinger KR, Cahill AG, Macones GA, Odibo AO. Association of first-trimester low PAPP-A levels with preterm birth. Prenat Diagn 2010; 30: 309-13.
- 13. Bacq Y, Sapey T, Brechot MC, Pierre F, Dubois F. Intrahepatic cholestasis of pregnancy: a French prospective study. Hepatology 1997; 26: 358-64.
- 14. Roncaglia N, Locatelli A, Arreghini A, et al. A randomised controlled trail of ursodeoxycholic acid and S-adenosyl-1-methionine in the treatment of gestational cholestasis. BJOG 2004; 111: 17-21.
- 15.Nunthapiwat S, Sekararithi R, Wanapirak C, Sirichotiyakul S , Tongprasert F , Srisupundit K , et al. Second Trimester Serum Biomarker Screen for Fetal Aneuploidies as a Predictor of Preterm Delivery: A Population-Based Study. Gynecol Obstet Invest. 2019;84(4):326–333. doi:10.1159/000495614
- 16. Chełchowska M, Gajewska J, Mazur J, et al. Serum pregnancy-associated plasma protein A levels in the first, second and third trimester of pregnancy: relation to newborn anthropometric parameters and maternal tobacco smoking. Arch Med Sci 2016; 12: 1256-62.
- 17. Gagnon A, Wilson RD, Audibert F . Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can 2008; 30: 918-49.
- 18. Mabuchi M, Kawamura I, Fushimi M, Takeshita S, Takakura S, Hirosumi J et al. Choleretic actions of insulin like growth factor I, prednisolone, and ursodeoxycholic acid in rats. Dig Dis Sci 2003; 48: 1398-405.
- 19.Tayyar AT, Tayyar A, Atakul T, Yayla CA, Kilicci Ç, Eser A et al. Could first- and second-trimester biochemical markers for Down syndrome have a role in predicting intrahepatic cholestasis of pregnancy?. Arch Med Sci. 2018;14(4):846–850. doi:10.5114/aoms.2017.69865
- 20. Arrese M, Macias RIR, Briz O, et al. Molecular pathogenesis of intrahepatic cholestasis of pregnancy. Expert Rev Mol Med 2008; 10: e9.
- 21. Hagenbuch B, Dawson P. The sodium bile salt cotransport family SLC10. Pflugers Arch 2004; 447: 566-70.
- 22. Vallejo M, Briz O, Serrano MA, Monte MJ , Marin JJG . Potential role of trans-inhibition of the bile salt export pump by progesterone metabolites in the etiopathogenesis of intrahepatic cholestasis of pregnancy. J Hepatol 2006; 44: 1150-7
Year 2021,
Volume: 18 Issue: 1, 643 - 647, 01.04.2021
Abstract
References
- 1.Williamson C, Geenes V. intrahepatic cholestasis of pregnancy .Obstet. Gynecol 2014;124:120-33.
- 2. Joshi D, James A, Quaglia A, Alberto Quaglia, Rachel H Westbrook, Michael A Heneghan.Liver disease in pregnancy. Lancet 2010;375:594-605
- 3. Arrese M, Reyes H, Intrahepatic cholestasis of pregnancy : a past and present riddle .Ann Hepatol 2006;5:202-5
- 4. Fisk NM, Bye W B ,Storey GN. Fetal outcome in obstetric cholestasis. BrJ Obstet Gynaecol 1988;95:1137–43.
- 5. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology 2004;40:467–74. 6. Laatikainen T, Ikonen E. Fetal prognosis in obstetric hepatosis. Ann Chir Gynaecol Fenn 1975;64:155–64.
- 7. Laatikainen T, Tulenheimo A. Maternal serum bile acid levels and fetal distress in cholestasis of pregnancy. Int J Gynaecol Obstet 1984;22:91–4.
- 8. Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines. Eur J Obstet Gynecol Reprod Biol. 2018;231:180–187. doi:10.1016/j.ejogrb.2018.10.041
- 9.Dixon PH, Williamson CJC, Clin Res Hepatology Gastroenterology.
- The pathophysiology of intrahepatic cholestasis of pregnancy. 2016 Apr;40(2):141-53. doi: 10.1016/j.clinre.2015.12.008.
- 10. Kang JH, Farina A, Park JH, et al. Down syndrome biochemical markers and screening for preeclampsia at first and second trimester: correlation with the week of onset and the severity. Prenat Diagn 2008; 28: 704-9.
- 11. Gutaj P, Wender-Ożegowska E, Brązert J. Maternal lipids associated with large-for-gestational-age birth weight in women with type 1 diabetes: results from a prospective single-center study. Arch Med Sci 2017; 13: 753-9.
- 12. Goetzinger KR, Cahill AG, Macones GA, Odibo AO. Association of first-trimester low PAPP-A levels with preterm birth. Prenat Diagn 2010; 30: 309-13.
- 13. Bacq Y, Sapey T, Brechot MC, Pierre F, Dubois F. Intrahepatic cholestasis of pregnancy: a French prospective study. Hepatology 1997; 26: 358-64.
- 14. Roncaglia N, Locatelli A, Arreghini A, et al. A randomised controlled trail of ursodeoxycholic acid and S-adenosyl-1-methionine in the treatment of gestational cholestasis. BJOG 2004; 111: 17-21.
- 15.Nunthapiwat S, Sekararithi R, Wanapirak C, Sirichotiyakul S , Tongprasert F , Srisupundit K , et al. Second Trimester Serum Biomarker Screen for Fetal Aneuploidies as a Predictor of Preterm Delivery: A Population-Based Study. Gynecol Obstet Invest. 2019;84(4):326–333. doi:10.1159/000495614
- 16. Chełchowska M, Gajewska J, Mazur J, et al. Serum pregnancy-associated plasma protein A levels in the first, second and third trimester of pregnancy: relation to newborn anthropometric parameters and maternal tobacco smoking. Arch Med Sci 2016; 12: 1256-62.
- 17. Gagnon A, Wilson RD, Audibert F . Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can 2008; 30: 918-49.
- 18. Mabuchi M, Kawamura I, Fushimi M, Takeshita S, Takakura S, Hirosumi J et al. Choleretic actions of insulin like growth factor I, prednisolone, and ursodeoxycholic acid in rats. Dig Dis Sci 2003; 48: 1398-405.
- 19.Tayyar AT, Tayyar A, Atakul T, Yayla CA, Kilicci Ç, Eser A et al. Could first- and second-trimester biochemical markers for Down syndrome have a role in predicting intrahepatic cholestasis of pregnancy?. Arch Med Sci. 2018;14(4):846–850. doi:10.5114/aoms.2017.69865
- 20. Arrese M, Macias RIR, Briz O, et al. Molecular pathogenesis of intrahepatic cholestasis of pregnancy. Expert Rev Mol Med 2008; 10: e9.
- 21. Hagenbuch B, Dawson P. The sodium bile salt cotransport family SLC10. Pflugers Arch 2004; 447: 566-70.
- 22. Vallejo M, Briz O, Serrano MA, Monte MJ , Marin JJG . Potential role of trans-inhibition of the bile salt export pump by progesterone metabolites in the etiopathogenesis of intrahepatic cholestasis of pregnancy. J Hepatol 2006; 44: 1150-7
There are 22 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 1, 2021 |
| Submission Date | May 26, 2020 |
| Acceptance Date | October 1, 2020 |
| Published in Issue | Year 2021 Volume: 18 Issue: 1 |
