The Effect of Hepatitis C on Maternal Bile Acid Level and the Fetal Left Ventricular Tei Index

• Main Authors: Kelly Cummings, Jesse Cottrell, Songthip Ounpraseuth, Ryan Stone, David G. Chaffin, Everett Magann
• Format: Article
• Language: English
• Published: Marshall University 2018-04-01
• Series: Marshall Journal of Medicine
• Subjects: cholestasis; fetus; heart; hepatitis C; pregnancy; Tei index
• Online Access: https://mds.marshall.edu/cgi/viewcontent.cgi?article=1165&context=mjm

Hepatitis C (HCV) is a common form of liver disease encountered in pregnancy. The purpose of this study is to evaluate if hepatitis C is associated with elevated maternal serum bile acids and abnormal fetal cardiac function measured by the left ventricular Tei index in the absence of intrahepatic cholestasis of pregnancy. This is a prospective cohort study on pregnant women with hepatitis C seen through Marshall University’s high-risk obstetrics clinic from 2013 to 2014. Women with hepatitis C had a laboratory evaluation and an ultrasound on the fetus to calculate the left ventricular Tei index. Demographic information and delivery outcomes were recorded. There were 77 participants with hepatitis C recruited and consented for this study. Sixty-one participants had complete laboratory and delivery information available for analysis. Twenty-one participants had a viral load that was not detectable and 40 participants had a detectable viral load. The mean viral load overall was 1943771 IU/mL (SD 4257143). There was no difference in Tei index between detectable and non-detectable viral load, 0.41 and 0.38 respectively (p = 0.41). There was no statistical difference in bile acid level between detectable and undetectable viral load, 12 and 8 µmol/L respectively (p = 0.05). Hepatic liver disease manifested by elevated hepatitis C viral load or elevated bile acids did not affect the left ventricular Tei index.