Document Detail


High mean platelet volume, low-grade systemic coagulation, and fibrinolytic activation are associated with pre-term delivery and low APGAR score in intrahepatic cholestasis of pregnancy.
MedLine Citation:
PMID:  20670095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was designed for evaluating coagulation parameters and low APGAR scores in pregnancies with intrahepatic cholestasis of pregnancy (ICP) vs. normal control pregnancies.
METHODS: We carried out a prospective case-control study by enrolling 40 women with ICP at the third trimester of pregnancy and 40 pregnant women without ICP.
RESULTS: Total bile acid levels (TBA), MPV, D-dimer, and umbilical artery systolic/diastolic ratio (UASDR) values were higher in women with ICP. Pregnancies complicated by low APGAR score exhibited significantly higher D-dimer levels than those of unimpaired fetal outcome in patients with ICP and control subjects. Levels of D-dimer were inversely correlated with 5'-Apgar score and positively associated with UASDR values in patients with ICP. Pregnancies that exhibited abnormal UASDR had higher total bile acid (TBA), D-dimer, MPV values and lesser 5'-Apgar score. In linear stepwise regression analyses, D-dimer independently and positively associated with UASDR, inversely associated with 5'-Apgar score in subjects with ICP; positively associated with mean platelet volume (MPV) values and inversely associated with 5'-Apgar score in all subjects.
CONCLUSION: Patients with ICP had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, and also D-dimer is associated with lower APGAR scores in both ICP and all pregnancies. Increased D-dimer levels suggest that hematological parameters could be potentially used as indicators of risk factor for assessing low APGAR score in ICP.
Authors:
Ayse G Kebapcilar; Cuneyt E Taner; Levent Kebapcilar; Giray Bozkaya
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1205-10     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Izmir Aegean Obstetrics and Gynecology Teaching Hospital, Izmir, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score*
Bile Acids and Salts / blood
Blood Platelet Disorders / complications*
Case-Control Studies
Cholestasis, Intrahepatic / blood,  complications*
Disseminated Intravascular Coagulation
Female
Fibrin Fibrinogen Degradation Products / analysis*
Humans
Infant, Newborn
Pregnancy
Pregnancy Complications, Hematologic*
Prospective Studies
Pulsatile Flow
Ultrasonography, Prenatal
Umbilical Arteries / ultrasonography
Young Adult
Chemical
Reg. No./Substance:
0/Bile Acids and Salts; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

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