Kosheleva Ol'ga Vladimirovna, Therapeutist, obstetrics unit, Samara Regional Clinical Hospital named after A.V. Seredavin (159 Tashkentskaya street, Samara, Russia), email@example.com
Kachkovskiy Mikhail Arkad'evich, Doctor of medical sciences, associate professor, head of sub-department of clinical medicine, “Reavis” Medical University (22 Chapaevskaya street, Samara, Russia), KachkovskyMA@reaviz.ru
Background. Cholestasis pregnancy (CP) develops as a result of nonconformity of liver function and increasing metabolic load during it. As a result of this process, the mechanisms of bile formation and biliary excretion are broken. Clinically CP is manifested by itching, rarely by jaundice and pain in the right hypochondria. The main laboratory markers of CP are: increased levels of bile acids, alkaline phosphatase, gammaglyutamiltranspeptidase, cholesterol, in more severe cases, increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Despite the favorable prognosis in women with CP may occur: premature birth, bleeding, fetal
hypoxia. The aim of the work is to determine the clinical and diagnostic criteria for complicated course of CP on a concrete example.
Materials and methods. A clinical case of CP in a woman with pregnancy induced by in vitro fertilization (IVF).
Results. A pregnant woman using IVF and appropriate clinical picture of CP show increased levels of ALT up to 1643 U/l (normal 0-35 U/l) and AST to 875,2 U/l (normal 0-35 U/l) on the background of moderate growth to 577,8 alkaline phosphatase U/l (normal 80-120 U/l). Autoimmune and viral liver lesions were excluded in the patient. According to scientific literature, such an increase in transaminases is not typical for it. Timely diagnosis and correct tactics of management of the pregnant woman contributed to the prevention of complications in the mother and fetus.
Conclusions. In pregnant with IVF is a need for more frequent monitoring of blood biochemical parameters, in particular ALT, AST, and alkaline phosphatase compared with women whose pregnancy is physiological. To date, timely delivery of pregnant women with CP is the most effective way to prevent complications and restore liver function, despite the positive effect of hepatoprotectors.
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