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Fetal Epicardial Fat Thickness in Intrahepatic Cholestasis of Pregnancy
Ayşegül Atalay1, Dilek Şahin21Van Education and Research Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, VAN, TURKEY2Ankara City Hospital, Department of Obstetrics and Gynecology, University of Health Sciences, ANKARA, TURKEY
INTRODUCTION: Our aim will focus on evidence suggesting a role for fetal epicardial fat thickness (fEFT) as a quantifiable independent risk factor for intrahepatic cholestasis of pregnancy (ICP).
METHODS: A prospective case-control study was conducted in pregnancies complicated with ICP. During the same period, healthy pregnant women at similar gestational weeks were randomly selected as the control group.
RESULTS: A total of 84 pregnant women participated in this study and we recruited 42 patients with ICP as study group and 42 healthy pregnant women as control group. Pregnant women in study group had significantly higher fEFT values and higher AST, ALT, direct and indirect bilirubin concentrations than those in control group (p<0.05). Study population was divided into two groups based on serum fasting total bile acid (TBA) levels of ≥ 40 µmol/L and <40 µmol/L as mild (n=30) and severe (n=12). The only significant parameter was direct bilirubin as higher levels in severe ICP group (p<0.05). The ROC curve analysis for assessing the performance of fEFT value in predicting ICP revealed that the area under the curve was 0.793 for ICP. The optimal fEFT cut- off value for predicting ICP was found as 0.085 mm with a sensitivity of 78.6% and specifity of 71.4%.
DISCUSSION AND CONCLUSION: The present study has shown that higher fEFT levels can be associated with prediction of ICP, and the study justifies the inclusion of fEFT as an aid in diagnosis alongside AST, ALT and bilirubins, as measurement of TBA levels is time consuming and expensive.
Manuscript Language: English