Fetal death in the women with cholestasis pregnancy

• Main Authors: M. A. Kachkovskiy, O. V. Kosheleva
• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2020-01-01
• Series: Медицинский совет
• Subjects: cholestatic liver disease in pregnant women; intrahepatic cholestasis; hepatosis of pregnancy; intrauterine fetal death; complications of pregnancy
• Online Access: https://www.med-sovet.pro/jour/article/view/5505
• ISSN: 2079-701X; 2658-5790

Background. The development of fetal death among pregnant women with cholestasis pregnancy (CP) is possible.Aim. The purposeи is to determine the interconnection between clinico-anamnestic and laboratory indicators of pregnant women with CP and fetal death.Patients and methods. 211 pregnant women were examined. The main group – 144 (68%) women with CP, controlgroup – 67 (32%) patients without symptoms of this disease. There are 2 subgroups depending on the presence or absence of fetal death among pregnant women with CP. A complex of standard clinical and diagnostic studies was performed, including obstetric ultrasound and cardiotocography. Results. In the group of patients with CP, postpartum hemorrhages (p<0.05), intrauterine fetal hypoxia (p<0.001) were significantly more frequent, fetal death was noted only in the main group (2.1%). In both subgroups miscarriages were more common in the history (p = 0.019). Most women with CHP had diseases of the hepatobiliary system, gestational hypertension and kidney disease (p<0.05). In the subgroup with fetal death arterial hypertension existed significantly more frequent before pregnancy (p<0.05). The itchy skin was extremely permanent among patients with CP and fetal death. The subgroup with fetal death significantly differed from the control group for hyperfermentemia both during pregnancy (alanine transaminase (ALT) – p<0.001, aspartate transaminase (AST) – p = 0.001, alkaline phosphatase (APH) – p = 0.001), and after delivery (ALT –p = 0.002, AST – p = 0.033, APH – p = 0.006).Conclusions. Women with CP, with a miscarriage in anamnesis or hypertension are in a risk group of fetal death. A more frequent study of the fetal condition is needed among patients with persistent itching at CP.