EVALUATING THE DIAGNOSTIC PERFORMANCE OF TOTAL BILE ACIDS AND TRANSAMINASES IN INTRAHEPATIC CHOLESTASIS OF PREGNANCY

Authors

  • Saba Nadeem Bahawal Victoria Hospital, Bahawalpur Pakistan
  • Sara Reza Quaid-e-Azam Medical College, Bahawalpur Pakistan
  • Hafiz Muhammad Salman Yousaf Quaid-e-Azam Medical College, Bahawalpur Pakistan
  • Nimrah Sattar Bahawal Victoria Hospital, Bahawalpur Pakistan

DOI:

https://doi.org/10.55629/pakjpathol.v32i3.727

Abstract

Objective: The objective of this study is to evaluate diagnostic performance of total bile acids and transaminases in intrahepatic cholestasis of pregnancy (ICP).

Material and Methods: This observational cross-sectional study was conducted at Gynecology & Obstetrics ward, Bahawal Victoria Hospital and Pathology Laboratory of Quaid-e-Azam Medical College, Bahawalpur. Thirty pregnant females with intrahepatic cholestasis of pregnancy were included in the study. Thirty age, parity and gestational age matched controls were selected. Total bile acids and alanine transaminases (ALT) were measured in each study subject. 

Results: The sensitivity and specificity for both total bile acids and ALT were calculated. Our study results showed a comparable sensitivity and specificity for both tests in patients with ICP. The rise in bile acids and ALT was statistically significant in ICP. The level of transaminases increased in proportion to total bile acids. Also, our study found an increased risk of preterm delivery, low birth weight and delivery by cesarean section in patients with ICP.

Conclusion: It is concluded that ALT can be used alternatively to total bile acids for the diagnosis of intrahepatic cholestasis of jaundice. Total bile acids are expensive and only a few laboratories in Pakistan are offering this service, making its access limited to general population. Whereas ALT is a cost effective and common test, its results are readily available with an additional benefit that no fasting sample is required. Hence, it is a more appropriate diagnostic test for ICP in our resource constraint setup.  

Key Words: Bile acids, Liver enzymes, Cholestasis, Pregnancy, Aminotransaminase.

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Published

30-09-2022