Zeynep Kamil Med J. 2012; 43(1): 11-14

Gebeliðin Kolestatik Hastalýðýnda Maternal ve Perinatal Sonuçlar

Turhan Aran, Mehmet Armaðan Osmanaðaoðlu, Recep Erin, Hasan Bozkaya
Karadeniz Technical University Faculty of Medicine Department of Obstetrics and Gynecology Trabzon

INTRODUCTION: to investigate maternal and perinatal outcomes in patients with intrahepatic cholestasis of pregnancy
METHODS: This study was conducted between 2008 and 2011 on patients with intrahepatic cholestasis of pregnancy. The study was designed in retrospective manner. All data were collected from hospital records. Total serum bile acid ≥ 15micromol/L or pruritus with increased serum transaminase levels were accepted as diagnostic criteria for intrahepatic cholestasis of pregnancy. The rate of preterm birth, fetal growth restriction and intrauterine fetal demise were the main outcomes. Maternal and neonatal records were also noted
RESULTS: A total of 24 patients with intrahepatic cholestasis of pregnancy were enrolled the study. The mean patients’ age and weight and BMI were 26.4±5.8 and 78.6±12.1 and 30.1±5.7 respectively. The mean serum total bile acid level was 112.7±87.1 mikromol/L. The mean gestational time was 263.4±9.9 at time of labor. The mean neonatal birthweight and the five-minute APGAR score 2975±454 g. And 9.7±0.5 respectively. Cesarean delivery rate was 25%. The rate of fetal growth restriction, preeclampsia and preterm birth were 8.3%, 12.5% and 25%. A patient was died due to postpartum hepatic failure.
DISCUSSION AND CONCLUSION: A physician should consider other clinical pathologies that can cause maternal death before the diagnosis of intrahepatic cholestasis of pregnancy

Keywords: Cholestasis of pregnancy, perinatal outcomes, maternal death

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Gebeliðin Kolestatik Hastalýðýnda Maternal ve Perinatal Sonuçlar

Turhan Aran, Mehmet Armaðan Osmanaðaoðlu, Recep Erin, Hasan Bozkaya
Karadeniz Teknik Üniversitesi Týp Fakültesi Kadýn Hastalýklarý ve Doðum AD Trabzon

GÝRÝÞ ve AMAÇ: Gebeliðin kolestatik hastalýðýnda maternal ve perinatal sonuçlarý araþtýrmak kolestatik hastalýðýnda maternal ve perinatal sonuçlarý araþtýrmak
YÖNTEM ve GEREÇLER: 2008–2011 yýllarý arasýnda gebeliðin kolestatik hastalýðý tanýsý ile kliniðimizde yatýrýlarak takip edilen hastalar üzerinde retrospektif olarak uygulandý. Serum safra asitleri ≥ 15micromol/L veya kaþýntý þikâyeti ile birlikte serum transaminaz deðerlerinde yükseklik varlýðý gebeliðin kolestatik hastalýðý taný kriterleri olarak belirlendi. Erken doðum, fetal büyüme kýsýtlýlýðý, preeklampsi, intrauterin fetal ölüm varlýðý, maternal ve neonatal sonuçlar kayýt edildi
BULGULAR: Toplam 24 hasta deðerlendirildi. Hastalarýn ortalama yaþý 26.4±5.8, kilosu 78.6±12.1 ve vücut kitle indeksi 30.1±5.7 idi. Doðumun gerçekleþtiði andaki gebelik süresi ortalama 263,4±9.9 gün idi. Serum safra asidi ortalamasý ise 112.7±87.1 mikromol/L idi. Ýki olguda (%8.3) fetal büyüme kýsýtlýlýðý ve 3 olguda (%12.5) preeklampsi altý olguda (%25) erken doðum geliþmiþti. Hiçbir hastada sarýlýk yoktu. Ortalama yenidoðan aðýrlýðý ve 5. dakika APGAR skoru sýrasý ile 2975±454 gram ve 9.7±0.5idi. Bir hasta postpartum dönemde karaciðer yetmezliði nedeni ile kaybedilmiþti.
TARTIÞMA ve SONUÇ: Gebelik kolestazý tanýsý koymadan önce benzer klinik tablo oluþturabilecek hastalýklarýn ayýrýcý tanýsý dikkatli bir þekilde yapýlmalýdýr.

Anahtar Kelimeler: Gebelik kolestazý, perinatal sonuçlar, anne ölümü

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