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What is Pregnancy Cholestasis?

 

Gestational cholestasis is a liver disease characterized by itching, elevated liver enzymes and increased serum bile acids in the last 3 months of pregnancy. These findings usually disappear within 2-3 weeks after pregnancy.

 

WHAT ARE THE SYMPTOMS?

 

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ Itching is the main symptom. Itching is disturbing and awakening from sleep. It is most often on the palms and soles of the feet, but can also spread to the entire body. Jaundice, weakness, loss of appetite and abdominal pain are rare findings.

 

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ Diagnosis; It is determined by elevation of liver enzymes in the blood and elevation of serum bile acids. Diagnosis is made when the serum bile acids level exceeds 10 μmol/L. When the serum bile acids level exceeds 40 μmol/L, the possibility of fetal complications increases.

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ Premature birth and related complications, meconium aspiration and sudden fetal death are the conditions that can be seen in the baby.

 

HOW SHOULD THE TREATMENT AND MANAGEMENT BE?

 

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ The aim is to relieve the mother's complaints, correct biochemical abnormalities and prevent the negative effects of the disease on the fetus.

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ Increase in serum bile acids is correlated with adverse effects on the fetus, and unfortunately, non-stress testing, ultrasonography, and maternal monitoring of fetal movements are insufficient to predict fetal well-being. In the light of current scientific data, it is recommended to perform a non-stress test twice a week.

      _cc781905-5cde-3194-bb3b3b-136bad  _cc781905-5cde-3194- ccde-3194cf13631365c5cf3b31994cbdc13653155cf -bb3b-136bad5cf58d_ Ursodeoxycholic acid is used in the treatment. It has been shown that ursodeoxycholic use reduces pruritus, serum bile acid level, and ALT level.

 

WHEN SHOULD BIRTH BE?

 

Studies show that it is appropriate to give birth at 37 weeks. Stethoid should be administered first to support maturation of the fetus's lungs. It is known that the use of ursodeoxycholic reduces itching, serum bile acid level and ALT level, but has no effect on sudden fetal death.

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