{"title":"妊娠肝内胆汁淤积症。","authors":"Luděk Kostka, Lukáš Hruban, Petra Morávková","doi":"10.48095/cccg2024405","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of this work is to summarize current scientific information focusing on the diagnosis, management, and treatment of intrahepatic cholestasis in pregnancy according to available literature.</p><p><strong>Methodology: </strong>Literature sources were searched using the Web of Science, Scopus, and PubMed/Medline databases.</p><p><strong>Conclusion: </strong>For the diagnosis and proper management of intrahepatic cholestasis of pregnancy, the postprandial serum bile acid value of the pregnant woman is crucial. Postprandial testing allows for a higher likelihood of identifying patients with significantly elevated bile acid levels. Bile acid values above 100 µmol/l, especially in the 3rd trimester, are associated with a significant risk of severe complications, particularly intrauterine fetal death. Ursodeoxycholic acid, the first-line treatment, according to available data, does not improve perinatal outcomes and has minimal effect on the sensation of itching in patients. The routine administration of ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy is controversial.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 5","pages":"405-410"},"PeriodicalIF":0.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intrahepatic cholestasis of pregnancy.\",\"authors\":\"Luděk Kostka, Lukáš Hruban, Petra Morávková\",\"doi\":\"10.48095/cccg2024405\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of this work is to summarize current scientific information focusing on the diagnosis, management, and treatment of intrahepatic cholestasis in pregnancy according to available literature.</p><p><strong>Methodology: </strong>Literature sources were searched using the Web of Science, Scopus, and PubMed/Medline databases.</p><p><strong>Conclusion: </strong>For the diagnosis and proper management of intrahepatic cholestasis of pregnancy, the postprandial serum bile acid value of the pregnant woman is crucial. Postprandial testing allows for a higher likelihood of identifying patients with significantly elevated bile acid levels. Bile acid values above 100 µmol/l, especially in the 3rd trimester, are associated with a significant risk of severe complications, particularly intrauterine fetal death. Ursodeoxycholic acid, the first-line treatment, according to available data, does not improve perinatal outcomes and has minimal effect on the sensation of itching in patients. The routine administration of ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy is controversial.</p>\",\"PeriodicalId\":43333,\"journal\":{\"name\":\"Ceska Gynekologie-Czech Gynaecology\",\"volume\":\"89 5\",\"pages\":\"405-410\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ceska Gynekologie-Czech Gynaecology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.48095/cccg2024405\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ceska Gynekologie-Czech Gynaecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.48095/cccg2024405","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的本研究旨在根据现有文献,总结当前关于妊娠期肝内胆汁淤积症的诊断、管理和治疗的科学信息:方法:使用 Web of Science、Scopus 和 PubMed/Medline 数据库检索文献资料:对于妊娠期肝内胆汁淤积症的诊断和正确治疗,孕妇餐后血清胆汁酸值至关重要。餐后检测更有可能发现胆汁酸水平明显升高的患者。胆汁酸值超过 100 µmol/l,尤其是在妊娠 3 个月时,会导致严重并发症,尤其是胎儿宫内死亡。根据现有数据,熊去氧胆酸作为一线治疗药物,并不能改善围产期预后,而且对患者的瘙痒感影响甚微。在治疗妊娠期肝内胆汁淤积症时常规使用熊去氧胆酸还存在争议。
Objective: The aim of this work is to summarize current scientific information focusing on the diagnosis, management, and treatment of intrahepatic cholestasis in pregnancy according to available literature.
Methodology: Literature sources were searched using the Web of Science, Scopus, and PubMed/Medline databases.
Conclusion: For the diagnosis and proper management of intrahepatic cholestasis of pregnancy, the postprandial serum bile acid value of the pregnant woman is crucial. Postprandial testing allows for a higher likelihood of identifying patients with significantly elevated bile acid levels. Bile acid values above 100 µmol/l, especially in the 3rd trimester, are associated with a significant risk of severe complications, particularly intrauterine fetal death. Ursodeoxycholic acid, the first-line treatment, according to available data, does not improve perinatal outcomes and has minimal effect on the sensation of itching in patients. The routine administration of ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy is controversial.