Turhan ARAN, Mehmet Armağan OSMANAĞAOĞLU, RECEP ERİN, Hasan BOZKAYA

Gebeliğin Kolestatik Hastalığında Maternal ve Perinatal Sonuçlar

Amaç: Gebeliğin kolestatik hastalığında maternal ve perinatal sonuçları araştırmak Materyal- Metot: kolestatik hastalığında maternal ve perinatal sonuçları araştırmak Materyal- Metot: 2008-2011 yılları arasında gebeliğin kolestatik hastalığı tanısı ile kliniğimizde yatırılarak takip edilen hastalar üzerinde retrospektif olarak uygulandı. Serum safra asitleri >= 15micromol/L veya kaşıntı şikâyeti ile birlikte serum transaminaz değerlerinde yükseklik varlığı gebeliğin kolestatik hastalığı tanı kriterleri olarak belirlendi. Erken doğum, fetal büyüme kısıtlılığı, preeklampsi, intrauterin fetal ölüm varlığı, maternal ve neonatal sonuçlar kayıt edildi Bulgular: Toplam 24 hasta değerlendirildi. Hastaların ortalama yaşı 26.4±5.8, kilosu 78.6±12.1 ve vücut kitle indeksi 30.1±5.7 idi. Doğumun gerçekleştiği andaki gebelik süresi ortalama 263,4±9.9 gün idi. Serum safra asidi ortalaması ise 112.7±87.1 mikromol/L idi. İki olguda (%8.3) fetal büyüme kısıtlılığı ve 3 olguda (%12.5) preeklampsi altı olguda (%25) erken doğum gelişmişti. Hiçbir hastada sarılık yoktu. Ortalama yenidoğan ağırlığı ve 5. dakika APGAR skoru sırası ile 2975±454 gram ve 9.7±0.5idi. Bir hasta postpartum dönemde karaciğer yetmezliği nedeni ile kaybedilmişti. Sonuçlar: Gebelik kolestazı tanısı koymadan önce benzer klinik tablo oluşturabilecek hastalıkların ayırıcı tanısı dikkatli bir şekilde yapılmalıdır.

Maternal and Perinatal Outcomes In Cases of Intrahepatic Cholestasis of Pregnancy

Objective: to investigate maternal and perinatal outcomes in patients with intrahepatic cholestasis of pregnancy Material and 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. Conclusion: A physician should consider other clinical pathologies that can cause maternal death before the diagnosis of intrahepatic cholestasis of pregnancy

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