The concentrations of bile acids and erythropoietin in pregnant women with intrahepatic cholestasis and the state of the fetus and newborn.

Intrahepatic cholestasis of pregnancy (ICP) is not a common complication of pregnancy, but may be a threat to fetal condition. The elevated level of bile acids denes ICP and determines its severity. Indicators of hepatocyte damage during ICP are elevated ALT and AST. The fetal condition in the ICP depends on the degree of liver damage. The most common complication is preterm delivery, but the risk of fetal death is currently around 3.5%. Erythropoietin is a peptide hormone produced mostly in the kidneys and liver due to tissue hypoxia. EPO concentration in the blood serum of pregnant women increases, because of its production in the placenta. Reducing the blood €ow through the fetal-placental unit is the cause of fetal complications associated with ICP. The reason for blood €ow the decrease is elevated TBA concentration. The hypothesis of the study assumed that in the course of ICP, elevated bile acids reduce blood €ow through the fetal-placental unit, which causes placental hypoxia, and which can lead to the increased secretion of EPO in the placenta. The aim of this study was to nd a correlation between high levels of bile acids and concetration of erythropoietin in the serum of women with ICP without anemia and renal dysfunction and to evaluate the course and outcome of pregnancy in women with ICP. Material and methods: 73 pregnant women from the Department of Obstetrics and Gynaecology, Institute of Mother and Child in Warsaw, were included in the study. 33 pregnant women with ICP were included in group I. Group II (control) consisted of 40 women with pregnancy without ICP. The inclusion criteria for the study in group I were as follows: TBA≥11 μmol/l; elevated liver enzymes: ALT>41 U/l and/ or AST>40 U/l; and the presence of pruritus (current or history). The exclusion criteria included: anemia (HGB 0.05). Conclusions: In the group of pregnant women with ICP there was no correlation between the concentration of bile acids and erythropoietin. Preterm delivery and worse neonatal outcome were more common in the ICP group, which indicates that perinatal care should be improved and further studies are needed.