Валеология: Здоровье, Болезнь, Выздоровление. 2020; : 23-30
ПЕРИНАТАЛЬНЫЙ ПРОГНОЗ ПРИ ВНУТРИПЕЧЕНОЧНОМ ХОЛЕСТАЗЕ БЕРЕМЕННЫХ
Аннотация
Внутрипеченочный холестаз (ВХБ) у беременных является наиболее распространенной болезнью печени во время беременности, так как его распространенность обуславливается этнической принадлежностью в зависимости от географического региона. По эпидемиологическим данным, ВХБ наблюдается у 0,2-1 % всех беременностей в европейских странах [1, 2, 3, 4], до 5,6 % в Соединенных Штатах и даже выше в странах Южной Америки. Регионами с самыми высокими показателями частоты считаются страны Скандинавии, Чили, Боливия, Индия и Пакистан [1, 5, 6]. Чаще всего он развивается во втором и третьем триместре беременности и связан с более высокой частотой неблагоприятных неонатальных исходов, таких как: преждевременные роды, респираторный дистресс-синдром новорожденных, околоплодные воды, окрашенные меконием, мертворождение. Этиология ВХБ у беременных недостаточно исследована, но, вероятно, является многофакторной с генетическим, экологическим и гормональным вкладом в развитие и тяжестью заболевания. До настоящего времени дородовое ведение, а также оптимальное время для родоразрешения остаются неясными. Не было показано ни одного метода мониторинга плода, который бы предполагал неблагоприятные перинатальные исходы или уменьшал бы их риск. Рекомендации различных национальных профессиональных обществ относительно сроков родов, осложненных ВХБ, также расходятся. Королевский колледж акушерства и гинекологии не поддерживает плановое раннее родоразрешение этих беременностей [10], в то время как Американский колледж акушеров и гинекологов поддерживает активное ведение протоколов родов при ВХБ [11]. Этот обзор был направлен на оценку результатов этой рутинной индукции у беременных женщин с ВХБ и исходы у новорожденных.
Список литературы
1. Lee N. M., Brady C. W. Liver disease in pregnancy // World journal of gastroenterology: WJG. – 2009. – Vol. 15. – № 8. – P. 897.
2. Floreani A., Gervasi M. T. New insights on intrahepatic cholestasis of pregnancy // Clinics in liver disease. – 2016. – Vol. 20. – № 1. – P. 177-189.
3. Smith D. D., Rood K. M. Intrahepatic Cholestasis of Pregnancy //Clinical Obstetrics and Gynecology. – 2020. – Vol. 63. – № 1. – P. 134-151.
4. Piechota J., Jelski W. Intrahepatic Cholestasis in Pregnancy: Review of the Literature // Journal of Clinical Medicine. – 2020. – Vol. 9. – № 5. – P. 1361.
5. Lee R. H. et al. The prevalence of intrahepatic cholestasis of pregnancy in a primarily Latina Los Angeles population // Journal of perinatology. – 2006. – Vol. 26. – № 9. – P. 527-532.
6. REYES H. et al. Prevalence of intrahepatic cholestasis of pregnancy in Chile // Annals of internal medicine. – 1978. – Vol. 88. – № 4. – P. 487-493.
7. Geenes V., Williamson C. Intrahepatic cholestasis of pregnancy // World journal of gastroenterology: WJG. – 2009. – Vol. 15. – №. 17. – P. 2049.
8. Friedlaender P., Osler M. Icterus and pregnancy // American Journal of Obstetrics and Gynecology. – 1967. – Vol. 97. – № 7. – P. 894-900.
9. Sjövall K., Sjövall J. Serum bile acid levels in pregnancy with pruritus (bii. e acids and steroids 158) // Clinica Chimica Acta. – 1966. – Vol. 13. – № 2. – P. 207-211.
10. Royal College of Obstetricians & Gynaecologists et al. Obstetric cholestasis // Green-top Guideline. – 2011. – № 43.
11. Late-preterm M. I. Medically Indicated Late-Preterm and Early-Term Deliveries. – 2019.
12. Jacquemin E., Cresteil D. Heterozygous non-sense mutation of the MDR3 gene in familial intrahepatic cholestasis of pregnancy // The Lancet. – 1999. – Vol. 353. – №. 9148. – P. 210-211.
13. Rosmorduc O., Poupon R. Low phospholipid associated cholelithiasis: association with mutation in the MDR3/ABCB4 gene // Orphanet journal of rare diseases. – 2007. – Vol. 2. – № 1. – P. 1-6.
14. Kawakita T. et al. Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy // American journal of obstetrics and gynecology. – 2015. – Vol. 213. – № 4. – P. 570. e1-570. e8.
15. Poupon R. et al. Genotype‐phenotype relationships in the low‐phospholipid‐associated cholelithiasis syndrome: a study of 156 consecutive patients // Hepatology. – 2013. – Vol. 58. – № 3. – P. 1105-1110.
16. Geier A. et al. Regulation of basolateral organic anion transporters in ethinylestradiol-induced cholestasis in the rat //Biochimica et Biophysica Acta (BBA)-Biomembranes. – 2003. – Vol. 1609. – № 1. – P. 87-94.
17. Dixon P. H., Williamson C. The pathophysiology of intrahepatic cholestasis of pregnancy // Clinics and Research in Hepatology and Gastroenterology. – 2016. – Vol. 40. – № 2. – P. 141-153.
18. Lee R. H. et al. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy // American journal of perinatology. – 2008. – Vol. 25. – №. 06. – P. 341-345.
19. Glantz A., Marschall H. U., Mattsson L. Å. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates //Hepatology. – 2004. – Vol. 40. – № 2. – P. 467-474.
20. Kondrackiene J., Kupcinskas L. Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems // World journal of gastroenterology: WJG. – 2008. – Vol. 14. – № 38. – P. 5781.
21. Mor M. et al. Intrahepatic cholestasis of pregnancy as a risk factor for preeclampsia // Archives of Gynecology and Obstetrics. – 2020. – Vol. 301. – № 3. – P. 655-664.
22. Arafa A., Dong J. Y. Association between intrahepatic cholestasis of pregnancy and risk of gestational diabetes and preeclampsia: a systematic review and meta-analysis // Hypertension in Pregnancy. – 2020.–P. 1-7.
23. Ovadia C. et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses // The Lancet. – 2019. – Vol. 393. – № 10174. – P. 899-909.
24. Sentilhes L. et al. Fetal death in a patient with intrahepatic cholestasis of pregnancy // Obstetrics & Gynecology. – 2006. – Vol. 107. – № 2. – P. 458-460.
25. Castaño G. et al. Bile acid profiles by capillary electrophoresis in intrahepatic cholestasis of pregnancy // Clinical science. – 2006. – Vol. 110. – № 4. – P. 459-465.
26. Prati D. et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels // Annals of internal medicine. – 2002. – Vol. 137. – № 1. – P. 1-10.
27. Kondrackiene J., Beuers U., Kupcinskas L. Efficacy and safety of ursodeoxycholic acid versus cholestyramine in intrahepatic cholestasis of pregnancy // Gastroenterology. –2005.–Vol. 129.–№ 3.– P. 894-901
28. Bicocca M. J., Sperling J. D., Chauhan S. P. Intrahepatic cholestasis of pregnancy: review of six national and regional guidelines // European Journal of Obstetrics & Gynecology and Reproductive Biology. – 2018. – Vol. 231. – P. 180-187.
29. Chappell L. C. et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial // The Lancet. – 2019. – Vol. 394. – № 10201. – P. 849-860.
30. Glantz A. et al. Intrahepatic cholestasis of pregnancy: amelioration of pruritus by UDCA is associated with decreased progesterone disulphates in urine // Hepatology. – 2008. – Vol. 47. – № 2. – P. 544-551.
31. Marschall H. U. et al. Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population‐based cohort study // Hepatology. – 2013. – Vol. 58. – № 4. – P. 1385-1391.
32. Arthuis C. et al. Perinatal outcomes of intrahepatic cholestasis during pregnancy: An 8-year case-control study // Plos one. – 2020. – Vol. 15. – № 2. – P. e0228213.
33. Frank Z. C. et al. Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids 40–99 µmol / L: A Decision Analysis [39N] // Obstetrics & Gynecology. – 2020. – Vol. 135. – P. 156S.
34. Frank Z. C. et al. Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids ≥ 100 µmol/ L : A Decision Analysis [38N] // Obstetrics & Gynecology. – 2020. –Vol. 135.– P. 155S-156S.
35. Cerneţchi O., Cemortan M., Sagaidac I. Etiopatogenia complicațiilor materno-fetale ale colestazei intrahepatice de sarcină // Buletin de Perinatologie. – 2019. – Vol. 85. – № 4. – P. 39-44.
36. Germain A. M. et al. Bile acids increase response and expression of human myometrial oxytocin receptor // American journal of obstetrics and gynecology. – 2003. – Vol. 189. – № 2. – P. 577-582.
37. Geenes V. et al. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population‐based case‐control study // Hepatology. –2014. – Vol. 59. – № 4. – P. 1482-1491.
38. Zecca E. et al. Intrahepatic cholestasis of pregnancy and neonatal respiratory distress syndrome // Pediatrics. – 2006. – Vol. 117. – № 5. – P. 1669-1672.
39. Zecca E. et al. Bile acid-induced lung injury in newborn infants: a bronchoalveolar lavage fluid study // Pediatrics. – 2008. – Vol. 121. – № 1. – P. e146-e149.
40. Alsulyman O. M. et al. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management // American journal of obstetrics and gynecology. – 1996. – Vol. 175. – № 4. – P. 957-960.
Valeology: Health - Illnes - recovery. 2020; : 23-30
PERINATAL PROGNOSIS FOR INTRAHEPATIC CHOLESTASIS OF PREGNANT WOMEN
Abstract
Intrahepatic cholestasis (HCB) in pregnant women is the most common liver disease during pregnancy, as its prevalence is determined by ethnicity depending on the geographical region. According to epidemiological data, HCB is observed in 0.2-1 % of all pregnancies in European countries [1, 2, 3, 4], up to 5,6 % in the United States and even higher in South America. Regions with the highest rates of frequency are considered the countries of Scandinavia, Chile, Bolivia, India and Pakistan [1, 5, 6]. Most often, it develops in the second and third trimester of pregnancy and is associated with a higher frequency of adverse neonatal outcomes, such as: premature birth, respiratory distress syndrome of newborns, amniotic fluid stained with meconium, stillbirth. The etiology of HCB in pregnant women is not well understood, but it is probably multifactorial with a genetic, environmental and hormonal contribution to the development and severity of the disease. To date, antenatal care, as well as the optimal time for delivery. Remains unclear: Not a single method of fetal monitoring has been shown that would suggest adverse perinatal outcomes or reduce their risk. The recommendations of various national professional societies regarding the delivery time for complicated HCB also differ. The Royal College of Obstetrics and Gynecology does not support the planned early delivery of these pregnancies [10], while the American College of Obstetrics and Gynecologists supports the active management of delivery protocols for HCB [11]. This review was aimed at evaluating the results of this routine induction in pregnant women with HCB and outcomes in newborns.
References
1. Lee N. M., Brady C. W. Liver disease in pregnancy // World journal of gastroenterology: WJG. – 2009. – Vol. 15. – № 8. – P. 897.
2. Floreani A., Gervasi M. T. New insights on intrahepatic cholestasis of pregnancy // Clinics in liver disease. – 2016. – Vol. 20. – № 1. – P. 177-189.
3. Smith D. D., Rood K. M. Intrahepatic Cholestasis of Pregnancy //Clinical Obstetrics and Gynecology. – 2020. – Vol. 63. – № 1. – P. 134-151.
4. Piechota J., Jelski W. Intrahepatic Cholestasis in Pregnancy: Review of the Literature // Journal of Clinical Medicine. – 2020. – Vol. 9. – № 5. – P. 1361.
5. Lee R. H. et al. The prevalence of intrahepatic cholestasis of pregnancy in a primarily Latina Los Angeles population // Journal of perinatology. – 2006. – Vol. 26. – № 9. – P. 527-532.
6. REYES H. et al. Prevalence of intrahepatic cholestasis of pregnancy in Chile // Annals of internal medicine. – 1978. – Vol. 88. – № 4. – P. 487-493.
7. Geenes V., Williamson C. Intrahepatic cholestasis of pregnancy // World journal of gastroenterology: WJG. – 2009. – Vol. 15. – №. 17. – P. 2049.
8. Friedlaender P., Osler M. Icterus and pregnancy // American Journal of Obstetrics and Gynecology. – 1967. – Vol. 97. – № 7. – P. 894-900.
9. Sjövall K., Sjövall J. Serum bile acid levels in pregnancy with pruritus (bii. e acids and steroids 158) // Clinica Chimica Acta. – 1966. – Vol. 13. – № 2. – P. 207-211.
10. Royal College of Obstetricians & Gynaecologists et al. Obstetric cholestasis // Green-top Guideline. – 2011. – № 43.
11. Late-preterm M. I. Medically Indicated Late-Preterm and Early-Term Deliveries. – 2019.
12. Jacquemin E., Cresteil D. Heterozygous non-sense mutation of the MDR3 gene in familial intrahepatic cholestasis of pregnancy // The Lancet. – 1999. – Vol. 353. – №. 9148. – P. 210-211.
13. Rosmorduc O., Poupon R. Low phospholipid associated cholelithiasis: association with mutation in the MDR3/ABCB4 gene // Orphanet journal of rare diseases. – 2007. – Vol. 2. – № 1. – P. 1-6.
14. Kawakita T. et al. Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy // American journal of obstetrics and gynecology. – 2015. – Vol. 213. – № 4. – P. 570. e1-570. e8.
15. Poupon R. et al. Genotype‐phenotype relationships in the low‐phospholipid‐associated cholelithiasis syndrome: a study of 156 consecutive patients // Hepatology. – 2013. – Vol. 58. – № 3. – P. 1105-1110.
16. Geier A. et al. Regulation of basolateral organic anion transporters in ethinylestradiol-induced cholestasis in the rat //Biochimica et Biophysica Acta (BBA)-Biomembranes. – 2003. – Vol. 1609. – № 1. – P. 87-94.
17. Dixon P. H., Williamson C. The pathophysiology of intrahepatic cholestasis of pregnancy // Clinics and Research in Hepatology and Gastroenterology. – 2016. – Vol. 40. – № 2. – P. 141-153.
18. Lee R. H. et al. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy // American journal of perinatology. – 2008. – Vol. 25. – №. 06. – P. 341-345.
19. Glantz A., Marschall H. U., Mattsson L. Å. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates //Hepatology. – 2004. – Vol. 40. – № 2. – P. 467-474.
20. Kondrackiene J., Kupcinskas L. Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems // World journal of gastroenterology: WJG. – 2008. – Vol. 14. – № 38. – P. 5781.
21. Mor M. et al. Intrahepatic cholestasis of pregnancy as a risk factor for preeclampsia // Archives of Gynecology and Obstetrics. – 2020. – Vol. 301. – № 3. – P. 655-664.
22. Arafa A., Dong J. Y. Association between intrahepatic cholestasis of pregnancy and risk of gestational diabetes and preeclampsia: a systematic review and meta-analysis // Hypertension in Pregnancy. – 2020.–P. 1-7.
23. Ovadia C. et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses // The Lancet. – 2019. – Vol. 393. – № 10174. – P. 899-909.
24. Sentilhes L. et al. Fetal death in a patient with intrahepatic cholestasis of pregnancy // Obstetrics & Gynecology. – 2006. – Vol. 107. – № 2. – P. 458-460.
25. Castaño G. et al. Bile acid profiles by capillary electrophoresis in intrahepatic cholestasis of pregnancy // Clinical science. – 2006. – Vol. 110. – № 4. – P. 459-465.
26. Prati D. et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels // Annals of internal medicine. – 2002. – Vol. 137. – № 1. – P. 1-10.
27. Kondrackiene J., Beuers U., Kupcinskas L. Efficacy and safety of ursodeoxycholic acid versus cholestyramine in intrahepatic cholestasis of pregnancy // Gastroenterology. –2005.–Vol. 129.–№ 3.– P. 894-901
28. Bicocca M. J., Sperling J. D., Chauhan S. P. Intrahepatic cholestasis of pregnancy: review of six national and regional guidelines // European Journal of Obstetrics & Gynecology and Reproductive Biology. – 2018. – Vol. 231. – P. 180-187.
29. Chappell L. C. et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial // The Lancet. – 2019. – Vol. 394. – № 10201. – P. 849-860.
30. Glantz A. et al. Intrahepatic cholestasis of pregnancy: amelioration of pruritus by UDCA is associated with decreased progesterone disulphates in urine // Hepatology. – 2008. – Vol. 47. – № 2. – P. 544-551.
31. Marschall H. U. et al. Intrahepatic cholestasis of pregnancy and associated hepatobiliary disease: a population‐based cohort study // Hepatology. – 2013. – Vol. 58. – № 4. – P. 1385-1391.
32. Arthuis C. et al. Perinatal outcomes of intrahepatic cholestasis during pregnancy: An 8-year case-control study // Plos one. – 2020. – Vol. 15. – № 2. – P. e0228213.
33. Frank Z. C. et al. Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids 40–99 µmol / L: A Decision Analysis [39N] // Obstetrics & Gynecology. – 2020. – Vol. 135. – P. 156S.
34. Frank Z. C. et al. Timing of Delivery in Intrahepatic Cholestasis of Pregnancy With Total Bile Acids ≥ 100 µmol/ L : A Decision Analysis [38N] // Obstetrics & Gynecology. – 2020. –Vol. 135.– P. 155S-156S.
35. Cerneţchi O., Cemortan M., Sagaidac I. Etiopatogenia complicațiilor materno-fetale ale colestazei intrahepatice de sarcină // Buletin de Perinatologie. – 2019. – Vol. 85. – № 4. – P. 39-44.
36. Germain A. M. et al. Bile acids increase response and expression of human myometrial oxytocin receptor // American journal of obstetrics and gynecology. – 2003. – Vol. 189. – № 2. – P. 577-582.
37. Geenes V. et al. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population‐based case‐control study // Hepatology. –2014. – Vol. 59. – № 4. – P. 1482-1491.
38. Zecca E. et al. Intrahepatic cholestasis of pregnancy and neonatal respiratory distress syndrome // Pediatrics. – 2006. – Vol. 117. – № 5. – P. 1669-1672.
39. Zecca E. et al. Bile acid-induced lung injury in newborn infants: a bronchoalveolar lavage fluid study // Pediatrics. – 2008. – Vol. 121. – № 1. – P. e146-e149.
40. Alsulyman O. M. et al. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management // American journal of obstetrics and gynecology. – 1996. – Vol. 175. – № 4. – P. 957-960.
