Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intrahepatic cholestasis of pregnancy is characterized by pruritus and raised maternal aminotransferases and bile acid in serum. It is correlated to increased risk of meconium staining of amniotic fluid, stillbirth and premature labour. A case of treatment with ursodeoxycholic acid from 26. to 36. week gestation is described. Ursodeoxycholic acid is an effective treatment of intrahepatic cholestasis of pregnancy, but the effect seems to decrease after a period.
 ...
PMID:[Intrahepatic cholestasis in pregnancy treated with ursodeoxycholic acid]. 1055 57

Cholestasis of pregnancy is a liver disorder that occurs during the second half of pregnancy, causing pruritus and elevated serum bile acid levels. Its etiology remains unknown but probably involves vascular and humoral immune responses, mediated by bile acids. This disorder is associated with substantially increased fetal morbidity and mortality. The most satisfactory treatment consists in delivering the fetus as soon as pulmonary maturation has occurred.
 ...
PMID:Fetal impact of cholestasis of pregnancy: experience at Tenon Hospital and literature review. 1086 78

The liver diseases of pregnancy are specific liver disorders during the pregnancy. The principal hepatic anomaly during hyperemesis gravidarum is a reversible augmentation of liver enzymes under reanimation. Intrahepatic cholestasis of pregnancy occur during the last 2 trimesters of pregnancy, manifested usually by pruritus preceeding a jaundice. The liver enzymes and the serum biliary acids are augmented. The acute fatty liver of pregnancy occur during the last trimester of pregnancy leading to early interruption of pregnancy which would help to diminish the elevated level of maternal and fetal mortality. The HELLP syndrome usually observed during the toxemia of pregnancy, associate an hemolysis elevation of liver enzymes and low platelets.
 ...
PMID:[Pregnancy-related liver diseases]. 1115 73

Intrahepatic cholestasis of pregnancy (ICP) is a disease predominantly of the third trimester of pregnancy, characterized primarily by pruritus, biochemical disturbances in liver enzymes, and less frequently jaundice. Although maternal pruritus can be severe, overall maternal morbidity and mortality associated with ICP is low. However, fetal morbidity and mortality are significant with associated risks for meconium-stained amniotic fluid, acute onset of fetal compromise, spontaneous preterm labor, and intrauterine fetal demise. Current literature recommends obstetric management that includes frequent fetal surveillance with delivery when fetal lung maturity has been established.
 ...
PMID:Intrahepatic cholestasis of pregnancy: a critical review. 1124 93

Intrahepatic cholestasis of pregnancy is one of the primary disorders of the liver that adversely affects maternal well-being and fetal outcome. Early identification of this condition, careful interdisciplinary monitoring, and prompt delivery at fetal maturity can improve outcomes in the mother and child. Although the cause is unclear, IHCP probably arises from a genetic predisposition for increased sensitivity to estrogens and progestogens and altered membrane composition and expression of bile ducts, hepatocytes, and canalicular transport systems. As a result, the elevations in maternal levels of bile acids and their molar ratios seen in healthy pregnancy rise further in IHCP patients. Also, as the normal fetal-to-maternal transfer of bile acids across the trophoblast is impaired, the excess bile acids with abnormal profiles accumulate and are toxic to the fetus. The management of IHCP is dictated by the increased risks of fetal distress, spontaneous preterm delivery, and sudden death, as well as by alleviating pruritus in the mother. These risks to the fetus rise progressively to delivery, regardless of serum levels of bile acids and ALT. Close monitoring of these markers is essential but does not prevent sudden fetal distress and death. Provision should be made to induce labor as soon as fetal lung maturity has been established. Ursodeoxycholic acid is the only therapy that has proven effective, albeit in small studies, in alleviating pruritus and restoring towards normal the abnormal profiles of bile acids and sulfated steroids in serum and other body fluids. Ursodeoxycholic acid seems to have no obvious adverse effects on the fetus, but experience is insufficient to draw conclusions regarding teratogenicity and prevention of adverse outcomes.
 ...
PMID:Intrahepatic cholestasis of pregnancy. 1129 Dec 41

Intrahepatic cholestasis of pregnancy (ICP) is a rare disorder of unknown etiology with a symptomatically distressing maternal course with pruritus as the chief complaint. ICP poses little medical risk to the mother, but poses significant risk to the fetus of perinatal mortality, preterm delivery, fetal distress, and meconium staining. ICP has a geographically variable prevalence and appears to have a heritable component. Current evidence suggests a susceptibility to derangements in the sulfation of steroid compounds, affecting the metabolism of progesterone and bile acids in the fetal/placental compartment. This impairs transport of bile acids across the placenta from the fetal to the maternal circulation. Exactly how this leads to fetal compromise is unknown. The most efficacious current medical management that improves both maternal symptoms and laboratory abnormalities is ursodeoxycholic acid (UDCA), a hydrophilic bile acid that alters the composition of the bile acid pool in maternal blood. When ICP is diagnosed, UDCA coupled with close maternal-fetal surveillance is indicated. Delivery should be effected near term, with confirmation of fetal lung maturity or earlier if fetal compromise is identified.
 ...
PMID:Intrahepatic cholestasis of pregnancy: review of the literature. 1177 31

Intrahepatic cholestasis of pregnancy (ICP) is a rare disease occurring mainly during the last trimester of pregnancy. Pruritus, often accompanied by excoriation of the skin but without other skin lesions, and elevated concentrations of bile acids are characteristic for this disorder. We present a 30-year-old woman with pruritus, elevated bile acids, ASAT and ALAT in the 22nd week of pregnancy. Treatment with ursodeoxycholic acid resulted in complete disappearance of the pruritus and normalisation of the bile acids, ASAT and ALAT. A healthy child was born at term. In the differential diagnosis of liver function abnormalities during pregnancy, ICP should be included. ICP responds very well to treatment with ursodeoxycholic acid, with no detrimental effects for mother and child.
 ...
PMID:Intrahepatic cholestasis of pregnancy. 1257 4

Intrahepatic cholestasis of pregnancy (or obstetric cholestasis) is a liver disorder that occurs in late pregnancy. Despite the potential adverse maternal and fetal/neonatal outcomes, cholestasis of pregnancy is often neglected and treated expectantly. More research is needed to improve the molecular and genetic understanding of the disease and to define a safe and effective medical treatment that improves clinical outcome. Ursodeoxycholic acid is considered to be a safe treatment option in the third trimester, but further randomized controlled trials are needed before ursodeoxycholic acid treatment can be generally recommended. Ursodeoxycholic acid is preferentially administered to patients with severe cholestasis (onset before week 33 or serum bile acid levels > 70 mmol/L) or to patients with a history of sudden fetal death, while maintaining close obstetric and regular biochemical surveillance (transaminases, bilirubin, and bile acid levels). Ursodeoxycholic acid can decrease pruritus and ameliorate liver tests, but effects on obstetric complications are ambiguous. S-Adenosylmethionine, dexamethasone, and cholestyramine can provide some relief of itching. Because none of these drugs have been shown to be harmful to mother or fetus, the individual woman and her clinician may decide whether to try one of the treatments described.
 ...
PMID:Intrahepatic Cholestasis of Pregnancy. 1262 71

Intrahepatic cholestasis of pregnancy occurs mainly in the final months of pregnancy, and is characterised by pruritus. Foetal morbidity and mortality are increased. The disorder is probably caused by a genetic defect in hormonal metabolism which becomes manifest during the altered hormonal balance in pregnancy. The total serum bile acid concentration is the diagnostic hallmark of the disease. Other routine laboratory tests have a low sensitivity and specificity. An active obstetric management with routine foetal assessments, caesarean section if the foetal condition worsens, and termination of the pregnancy at 37-38 weeks, probably prevents a large proportion of complications. Ursodeoxycholic acid treatment should be considered especially in patients with severe pruritus or complications in previous pregnancies.
 ...
PMID:[Intrahepatic cholestasis of pregnancy]. 1281 16

Intrahepatic cholestasis of pregnancy is a hepatopathy that occurs in the second or third trimester and accounts for 20% of cases of jaundice occurring in pregnancy. Both genetic and hormonal factors appear to play important roles in its development. The leading symptom is pruritus, and jaundice is common. Transaminases, serum bile acids and bilirubin are typically elevated, while gamma-GT is usually normal. For the differential diagnosis, in particular viral hepatitis, cholelithiasis, gestosis and acute fatty liver of pregnancy must be excluded. While the prognosis of intrahepatic cholestasis of pregnancy for the mother is good, the associated increased tendency for a premature birth represents a potential risk for the child. Early treatment with ursodeoxycholic acid appears to have a positive influence on both the mother's symptoms and the course of the pregnancy. Should the symptoms persist after delivery, consideration must be given to a chronic hepatopathy.
 ...
PMID:[Intrahepatic cholestasis in pregnancy. What to consider in jaundice and pruritus]. 1461 Aug 64


<< Previous 1 2 3 4 5 6 7 8 9 Next >>