Severe preeclampsia following intrahepatic cholestasis of Pregnancy. Case Report
DOI:
https://doi.org/10.35954/SM2017.36.1.7Keywords:
Intrahepatic cholestasis; Eclampsia; Preeclampsia; Fetal Suffering.Abstract
Evidence has been reported linking intrahepatic cholestasis of pregnancy with preeclampsia. Similar inflammatory processes occur in these two pathologies.
We report the case of a 30-year-old patient who, at 31 weeks of pregnancy in her second gestation, developed cholestasis gravidarum as a complication of preeclampsia. pregnancy, she developed cholestasis gravidarum as a complication, due to pruritus and increase of bile acids in blood, associated with fetal distress. associated with mild fetal distress. She receives treatment with ursodeoxycholic acid in order to reduce bile acid decrease the concentration of bile acids in the blood.
During her evolution she presented severe preeclampsia due to systolic blood pressure of 160 mm Hg and proteinuria of 16.9 g/l. She was admitted to special care where she was monitored, and received treatment with magnesium sulfate and interruption of pregnancy by cesarean section at 33 weeks. We can conclude that patients with intrahepatic cholestasis of pregnancy due to the increased risk of preeclampsia should be monitored more frequently for blood pressure, proteinuria/creatininuria index, functional and liver enzymogram and fetal biophysical profile.
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(1) Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol 2009; 15(17):2049-66.
(2) Reyes H, Gonzalez M, Ribalta J, Aburto H, Matus C, Schramm G, et al. Prevalence of intrahepatic cholestasis of pregnancy in Chile. Ann Intern Med 1978; 88(4):487-93.
(3) Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol 2014; 124(1):120-33.
(4) LammertF,MarschallHU,GlantzA,MaternS. Intrahepaticcholestasisofpregnancy:molecular pathogenesis, diagnosis and management.J Hepatol 2000; 33(6):1012-21.
(5) Geenes V, Chappell LC, Seed PT, Steer PJ, Knight M, Williamson C. Association of sever e intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology 2014; 59(4):1482-91.
(6) Brouwers L, Koster MP, Page-Christiaens GC, Kemperman H, Boon J, Evers IM, et al. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. Am J Obstet Gynecol 2015; 212(1):100.e1-7.
(7) Jebbink J, Tabbers M, Afink G, Beuers U, Elferink RO, Ris-Stalpers C, et al. HELLP syndrome preceded by intrahepatic cholestasis of pregnancy: one serious itch. BMJ Case Rep 2014; 2014: bcr2013203208.
(8) Raz Y, Lavie A, Vered Y, Goldiner I, Skornick-Rapaport A, Landesber Asher Y, et al. Severeintrahepatic cholestasis of pregnancy is a risk factor for preeclampsia in singleton and twin pregnancies.Am J Obstet Gynecol 2015; 213(3):395.e1-8.
(9) American College of Obstetricians and Gynecologists Committee on Practice Bulletins: Obstetrics. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Obstet Gynecol 2002; 99(1):159-67.
(10) Goulis DG, Walker IA, de Swiet M, Redman CW, Williamson C. Preeclampsia with abnormal liver function tests is associated with cholestasis in a subgroup of cases. Hypertens Pregnancy 2004; 23(1):19-27.
(11) Anderson UD, Olsson MG, Kristensen KH, Åkerström B, Hansson SR. Review: biochemical markers to predict preeclampsia. Placenta 2012; 33 Suppl: S42-7.
(12) Perez MJ, Briz O. Bile-acid-induced cell injury and protection. World J Gastroenterol 2009; 15(14):1677-89.
(13) Li H, Gu B, Zhang Y, Lewis DF, Wang Y. Hypoxia-induced increase in soluble Flt-1 production correlates with enhanced oxidative stress in trophoblast cells from the human placenta. Placenta 2005; 26(2-3):210-7.
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