Location
Moultrie, GA
Start Date
8-5-2024 1:00 PM
End Date
8-5-2024 4:00 PM
Description
Introduction:
Intrahepatic cholestasis of pregnancy (ICP) is a rare but potentially serious condition characterized by impaired bile flow, leading to elevated levels of bile acids in maternal serum. This case study highlights the importance of recognizing and managing ICP due to its associated risks, including adverse maternal and fetal outcomes.
Case presentation:
We present the case of a 25-year-old gravida-2 para-0 woman who presented with diffuse itching over her entire body in the third trimester of pregnancy. Laboratory investigations revealed significantly elevated bile acids, confirming the diagnosis of ICP. Prompt initiation of management, including pharmacological therapy and close monitoring, resulted in favorable maternal and fetal outcomes. Through this case, we emphasize the significance of early detection, appropriate intervention, and multidisciplinary management of ICP to mitigate associated risks and ensure optimal outcomes for both mother and baby.
Discussion:
The exact cause of cholestasis of pregnancy is not fully understood. Multiple studies have explored the influence of reproductive hormones on the development of cholestasis of pregnancy. Several investigations have indicated a correlation between elevated estrogen levels and specific conditions, including multiple pregnancies, ovarian hyperstimulation, and the occurrence of ICP in the later stages of the second trimester. Typically, ICP manifests during the late second trimester, coinciding with peak estrogen levels during pregnancy. It is hypothesized that estrogen suppresses the expression of hepatic bile acid receptors and hepatic biliary canalicular transport proteins. Thus, this phenomenon causes impairment of hepatic bile acid regulation and explains why lab values demonstrate increased levels of bile acids. The symptoms of ICP resemble those observed in women using contraceptive pills containing high levels of estrogen. This impairment may lead to potential poor fetal outcomes, ranging from meconium stained amniotic fluid, preterm delivery, and intrauterine fetal demise. While there is not a specific identifiable cause, it is essential to identify this condition to avoid undesirable fetal outcomes.
Embargo Period
7-1-2024
Included in
Navigating Obstetric Cholestasis: A Comprehensive Case Study on Diagnosis, Management, and Maternal-Fetal Outcomes
Moultrie, GA
Introduction:
Intrahepatic cholestasis of pregnancy (ICP) is a rare but potentially serious condition characterized by impaired bile flow, leading to elevated levels of bile acids in maternal serum. This case study highlights the importance of recognizing and managing ICP due to its associated risks, including adverse maternal and fetal outcomes.
Case presentation:
We present the case of a 25-year-old gravida-2 para-0 woman who presented with diffuse itching over her entire body in the third trimester of pregnancy. Laboratory investigations revealed significantly elevated bile acids, confirming the diagnosis of ICP. Prompt initiation of management, including pharmacological therapy and close monitoring, resulted in favorable maternal and fetal outcomes. Through this case, we emphasize the significance of early detection, appropriate intervention, and multidisciplinary management of ICP to mitigate associated risks and ensure optimal outcomes for both mother and baby.
Discussion:
The exact cause of cholestasis of pregnancy is not fully understood. Multiple studies have explored the influence of reproductive hormones on the development of cholestasis of pregnancy. Several investigations have indicated a correlation between elevated estrogen levels and specific conditions, including multiple pregnancies, ovarian hyperstimulation, and the occurrence of ICP in the later stages of the second trimester. Typically, ICP manifests during the late second trimester, coinciding with peak estrogen levels during pregnancy. It is hypothesized that estrogen suppresses the expression of hepatic bile acid receptors and hepatic biliary canalicular transport proteins. Thus, this phenomenon causes impairment of hepatic bile acid regulation and explains why lab values demonstrate increased levels of bile acids. The symptoms of ICP resemble those observed in women using contraceptive pills containing high levels of estrogen. This impairment may lead to potential poor fetal outcomes, ranging from meconium stained amniotic fluid, preterm delivery, and intrauterine fetal demise. While there is not a specific identifiable cause, it is essential to identify this condition to avoid undesirable fetal outcomes.
Comments
Presented by Mailyn Cruz.