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Gebeliğin İntrahepatik kol est azı: İki Olgu Sunumu

Intrahepatic Cholestasis Of Pregnancy: Two Cases Report

Journal Name:

  • Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Intrahepatic cholestasis of pregnancy is a rare disorder of unknown etiology with a symp-tomatically distressing maternal course with pruritus as the chief complaint. Intrahepatic cholestasis of pregnancy poses little risk to the mother, but poses significant risk to the fetus of perinatal mortality, preterm delivery, fetal distress, and meconium staining. It has a georaphically variable prevalance and appears to liave a heritable component. Current evidence suggests a susceptibility to derangements in the sulfation of steroid compounds, affecting the metabolism of progesterone and bile acids in the fetal/placenta I compartment. This impairs transport of bile acids across the placenta from the fetal to the maternal circulation. Exactly how this leads to fetal compromise is unknown. The most efficacious current medical management that improves both maternal symptoms and laboratory abnormalities is ursodeoxycholic acid. When intrahepatic cholestasis of pregnan cy is diagnosed, Cholestramin or ursodeoxycholic acid coupled with close maternal-fetal sur-veilance is indicated. Delivery should be effected near term , with conf irmation of fetal lung maturity or earlier if fetal compromise is identified. Therefore, We aim tointroduce intrahepatic cholestasis of pregnancy with guide ofenglish literature because of two cases.
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Abstract (Original Language): 
Gebeliğin intrahepatik kolestazı esas şikayeti pruritis olan ve etiyolojisi bilinmeyen nadir bir hastalıktır. Hastalık annede minimal rnedikal risklere sebeb olurken fetusda preterm doğum , fetal distres ve mekonyum pasajı gibi ciddi problemlere yol açabilir. Dağılımı coğrafik farklılık gösterir ve genetik bir eğilim ile birliktedir. Steroid bileşiklerin sulfatlanma mekanizmasındaki bozulma safra asitlerinin fetus ve plasental bölümde metabolizmasını etkilediği düşünülmektedir. Bu safra asitlerinin fetustan plsenta vasıtasıyla maternal dolaşıma transportunu bozar. Günümüzde en iyi rnedikal yönetim kolestramin ve ursodeoksikolik asittir. Gebeliğin intrahepatik kolestazı tanısı konduğunda kolestramin veya ursodeoksikolik asit ile birlikte sıkı bir anne ve fetus takibi gerekir. Doğum fetal akciğer olgunluğa eriştiğinde terme yakın dönemde veya fetal, bozulma oluşursa daha erken dönemde gerçekleştirilmelidir. Fetal ve maternal komplikasyonlara yol açan bu dermatolojik başvuruya sebeb olabilen bu hastalığı iki vakamız nedeni ile ingilizce literatür ışığında sunmayı amaçladık.
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  • 4
46-49
  • Turkish

REFERENCES

References: 

1. Furlıoff A. Itching in pregnancy. Acta Med Scand 1974; 196: 403-410.
2. Roger D, Vaillant L, Fignon A. Specific pruritic diseases of pregnancy: A prospective study of 3192 pregnant women. Arch Dermatol 1994; i30: 734-739.
3. Shornick J. Dermatoses of pregnancy. Semin Cutan Med Surg 1998; 17: 172-181.
4. Reyes H. The spectrumof liver and gastrointestinal disease seen in cholestasis of pregnancy. Gastroenterol Clin North Am 1992; 21: 905¬917.
5. Fisk N, Storey G. Fetal outcome in obstetric cholestasis. Br J Obstet Gynaecol 1988; 95: 1137-1143.
6. Shaw D, Frohlich J, Wittmann B. A prospective study of 18 patients with cholestasis of pregnancy. Am J Obstet Gynecol 1982; 142: 621¬625.
7. MacSween R, Antony P, Scheuer P, eds . Pathology of the Liver . New York: Curchill Livingstone, 1987, pp 456-462.
8. Winston G, Lewis C. Dermatoses of pregnancy J Am Acad Dermatol 1982; 6: 977-998.
9. Holmes R, Black M. The specific dermatoses of pregnancy. J Am Acad Dermatol 1983; 8: 405-412.
10. LaatikainenT, Ikonen E. Serum bile acids in cholestasis of pregnancy. Obstet Gynecol1976; 50:313-318.
11. Riikonen S, Savonius H, GyllUngH. Oral guar gum: A gel-forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy. Obstet Gynecol Surv 2000; 55: 674-675.
12. Reyes H, Ri balta J, Gonzales M. Sulfobromopthalein clearance tests before and after ethynil estradiol administration, in women and men with family history of intrahepatic cholestasis of pregnancy. Gastroenterology 1981; 81: 226-231.
13. Gordon B, Sherard 111, Samuel M, Atkinson Jr. Focus on primary care pruritic dermatologi-cal conditions in Pregnancy. Obstet Gynecol Surv 2001; 56: 427-432.
14. Reyes H. Review intrahepatic cholestasis . A puzzling disorder of pregnancy . J Gastroenterol Hepatol 1997; 12:211-216.
SDÜ Tıp Fakültesi Dergisi 2000; 7(4): 46-49
15. Mullually BA, Hansen WF. Intrahepatic cholestasis of pregnancy; Review of literature. Obstet Gynecol Surv 2002; 57: 47-52.
16. Pagan EA, intrahepatic cholestasis of pregnancy. Clin Liver Dis 1999; 3: 603-632.
17. Mazzella G, Nicola R, Francesco A, Patrizia S, Luciano B, Anna M, Guiliana S, Antonia C, Giovanni N,Constance M, Dav ide F, EnricoR. Ursodeoxycholic acid administration in patients with cholestasis of pregnancy: effect on primary bile acid in babies and mother. Hepatology 2001; 33: 504-508.

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