Serum bile acids in the early diagnosis of intrahepatic cholestasis of pregnancy
Heikkinen, J.
Obstetrics and Gynecology 61(5): 581-587
1983
ISSN/ISBN: 0029-7844 PMID: 6835612 Document Number: 211659
The sensitivities of serum bile acid assays and some conventional liver function tests were studied in the early diagnosis and follow-up of intrahepatic cholestasis ), alkaline phosphatase (AP), .gamma.-glutamyltranspeptidase (.gamma.-GT) and total and direct bilirubin were measured from the 16th to the 20th wk of pregnancy until 35-60 days postpartum. When the 1st pathologic CA value appeared in the group of 8 patients followed-up before symptoms, in every case the CA:CDCA ratio was over 1; there were mild itching symptoms in 4 cases, pathologically increased SGPT in 4 cases elevated CDCA, AP and .gamma.-GT levels in 3 cases and elevated SGOT values in 1 case. Total and direct bilirubin concentrations were normal in all cases. Of all the analyses of the intrahepatic cholestasis of pregnancy patients (no. = 45) before delivery, CA was over the normal reference limit in 71%, CDCA in 57%, SGPT in 65%, SGOT in 59%, AP in 46%, .gamma.-GT in 35%, total bilirubin in 17% and direct bilirubin in 38%. The correlation coefficients were significant (P < 0.001) between the primary bile acids and SGPT, SGOT, AP and total and direct bilirubins. In the early diagnosis and follow-up of IHC of pregnancy the most sensitive indicators are: an increased CA level, a CA:CDCA ratio over 1 and an increase in SGPT activity.