Liver damage parameters and peripheral blood parameters for prediction and diagnosis of intrahepatic cholestasis in pregnancy.
J Obstet Gynaecol Res
; 50(2): 196-204, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37994385
ABSTRACT
OBJECTIVE:
Intrahepatic cholestasis of pregnancy (ICP) manifests in late pregnancy. Elevated serum bile acid is a diagnostic criterion however, its measurement is troublesome. Prediction of ICP by blood markers is not established. Serum bile acid level is associated with liver damage and inflammation. We hypothesized that the following markers could predict the occurrence of ICP and have diagnostic value for it Liver damage-indicating scores (albumin-bilirubin [ALBI], Model for End-Stage Liver Disease [MELD], aspartate aminotransferase-to-platelet ratio [APRI]) and inflammatory markers (platelet-to-lymphocyte ratio [PLR] and neutrophil-to-lymphocyte ratio [NLR]).METHODS:
Eighty ICP patients and 200 controls were studied. The values of MELD, APRI, ALBI, PLR, and NLR were measured in the 1st trimester and at the time of diagnosis.RESULTS:
Patients with ICP had significantly higher ALBI, MELD, and APRI scores both in the first trimester and at diagnosis. Multivariate logistic regression (MLR) showed that age, ALBI, MELD, and APRI scores were statistically significant (p < 0.05). By receiver operating characteristic (ROC) analysis, the sensitivity of MELD, ALBI, APRI, and NLR in the first trimester was 62%, 73%, 58%, and 29%, respectively, and MELD, ALBI, APRI, and PLR at diagnosis was 28%, 38%, 57%, and 8%, respectively, with a fixed false-positive rate of 10%.CONCLUSION:
This study has demonstrated the usability of the MELD, ALBI, and APRI scores in predicting and diagnosing ICP. They are easy to obtain and might be used in routine practice.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Colestase Intra-Hepática
/
Doença Hepática Terminal
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article