scholarly journals Pregnancy and the Biliary System

1990 ◽  
Vol 4 (5) ◽  
pp. 209-214 ◽  
Author(s):  
Helga Witt ◽  
J Joseph Connon
Keyword(s):  
Pregnant Women ◽  
Chenodeoxycholic Acid ◽  
Bile Salts ◽  
Second Trimester ◽  
Biliary Cholesterol ◽  
Ratio Increase ◽  
Gallbladder Function ◽  
Gallbladder Contractility ◽  
Cholesterol Saturation ◽  
Acid Ratio

Alterations in the synthesis and secretion of bile salts and cholesterol and in gallbladder function occur during pregnancy. These changes are related to the effects of estrogen and progesterone. Biliary cholesterol saturation and the cholic acid/chenodeoxycholic acid ratio increase. Progesterone also diminishes gallbladder contractility and emptying. Gallstones occur in 2.5 to 11% of pregnant women and are associated with cholecystitis in 0.008 to 0.1% of pregnant women. Operative treatment should be deferred if possible until after delivery; failing that, surgery is best done in the second trimester. Endoscopic pap1llotomy may prove to be the best therapy for choledocholithiasis.

Action de l'acide cholique et de l'acide chénodesoxycholique sur la sécrétion biliaire de la souris. Effet de l'addition du β-sitostérol

1980 ◽  
Vol 58 (9) ◽  
pp. 1058-1062 ◽  
Author(s):  
Ch. Marteau ◽  
M. O. Reynier ◽  
C. Crotte ◽  
A. Mule ◽  
S. Mathieu ◽  
...  
Keyword(s):  
Intestinal Absorption ◽  
Experimental Model ◽  
Cholic Acid ◽  
Chenodeoxycholic Acid ◽  
Bile Salts ◽  
Dry Weight ◽  
Biliary Secretion ◽  
Hepatic Cholesterol ◽  
Biliary Cholesterol ◽  
Specific Effects

After this time, the cholesterol intestinal absorption and the biliary secretion of lipids were measured. The biliary secretion of cholesterol, the total hepatic cholesterol (23 mg/g liver dry weight), and the intestinal absorption of cholesterol (90% administered dose) were higher in mice fed with cholic acid than in mice fed with chenodeoxycholic acid (hepatic cholesterol, 9.6 mg/g liver dry weight; absorption, 65% administered dose).The addition of β-sitosterol to the diet supplemented with cholic acid decreased the cholesterol intestinal absorption and the biliary secretion of cholesterol so that both became similar to that obtained with chenodeoxycholic acid.These results indicate that in mice, as in man, cholic acid elicits a higher cholesterol biliary secretion than chenodeoxycholic acid. In this experimental model, the distinct effect on the biliary cholesterol of these two bile salts is due to their specific effects on the intestinal absorption of cholesterol.

A Combination of Chenodeoxycholic Acid and Ursodeoxycholic Acid is more Effective than Either Alone in Reducing Biliary Cholesterol Saturation

Hepatology ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 334S-339S ◽  
Author(s):  
Mauro Podda ◽  
Massimo Zuin ◽  
Maria L. Dioguardi ◽  
Susanna Festorazzi ◽  
Nicola Dioguardi
Keyword(s):  
Ursodeoxycholic Acid ◽  
Chenodeoxycholic Acid ◽  
Biliary Cholesterol ◽  
Cholesterol Saturation

Differing effects of ursodeoxycholic or chenodeoxycholic acid on biliary cholesterol saturation and bile acid metabolism in man

1982 ◽  
Vol 27 (2) ◽  
pp. 161-168 ◽  
Author(s):  
J. L. Thistle ◽  
N. F. Larusso ◽  
A. F. Hofmann ◽  
J. Turcotte ◽  
G. L. Carlson ◽  
...  
Keyword(s):  
Bile Acid ◽  
Chenodeoxycholic Acid ◽  
Acid Metabolism ◽  
Bile Acid Metabolism ◽  
Biliary Cholesterol ◽  
Cholesterol Saturation

Does Active Smoking Influence the Second Trimester Biochemical Markers Concentrations?

2017 ◽  
Vol 68 (10) ◽  
pp. 2234-2236
Author(s):  
Dan Navolan ◽  
Florin Birsasteanu ◽  
Adrian Carabineanu ◽  
Octavian Cretu ◽  
Diana Liana Badiu ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Cigarette Smoke ◽  
Chorionic Gonadotropin ◽  
Reference Values ◽  
Biochemical Markers ◽  
Smoking Status ◽  
Active Smoking ◽  
Second Trimester ◽  
Harmful Effects

Cigarette smoke contains over 7000 different substances some of them exerting harmful effects on embryo and pregnant woman. Nowadays 15 % of adult people and around 10-15% of pregnant women smoke. Previous studies showed that cigarette smoke compounds could exert pharmacodinamic effects and influence some of the second trimester biochemical markers concentration. Therefore there is a need to adjust the reference values of second trimester markers depending of the smoker status. The aim of our study was to analyse which of the markers are influenced by smoking and whether the software used to calculate the risk for aneuploidies is able to counterbalance this influence. Alpha-fetoprotein (AFP), chorionic gonadotropin hormone (hCG) and free estriol (uE3) values were measured in second trimester sera of 1242 pregnant women: 1089 non-smokers and 153 smokers. Only hCG second trimester values were influenced by smoking whereas AFP and uE3 values were not. The correction of medians according to the smoking status was able to counterbalance this effect.

Is there a Need for Own Median Calculation in the Second Trimester Biochemical Markers Screening?

2017 ◽  
Vol 68 (5) ◽  
pp. 1070-1072
Author(s):  
Dan Navolan ◽  
Mirela Nicolov ◽  
Simona Vladareanu ◽  
Ioana Ciohat ◽  
Marius Craina ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Second Trimester ◽  
Established Method ◽  
Crown Rump Length ◽  
The Difference ◽  
Fetal Aneuploidies ◽  
Singleton Pregnancies

Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.

scholarly journals Sertraline concentrations in pregnant women are steady and the drug transfer to their infants is low

2021 ◽  
Author(s):  
E. Heinonen ◽  
M. Blennow ◽  
M. Blomdahl-Wetterholm ◽  
M. Hovstadius ◽  
J. Nasiell ◽  
...  
Keyword(s):  
Cord Blood ◽  
Pregnant Women ◽  
Plasma Concentrations ◽  
Relative Difference ◽  
Interindividual Variation ◽  
Therapeutic Drug ◽  
Cytochrome P450 Enzyme ◽  
Second Trimester ◽  
P450 Enzyme ◽  
Placental Passage

Abstract Purpose Sertraline, a selective serotonin reuptake inhibitor (SSRI), is one of the most commonly used antidepressant during pregnancy. Plasma sertraline concentrations vary markedly between individuals, partly explained by variability in hepatic drug metabolizing cytochrome P450-enzyme activity. Our purpose was to study the variability in the plasma concentrations in pregnant women and the passage to their infants. Method Pregnant women with moderate untreated depression were recruited in 2016–2019 in Stockholm Region and randomized to treatment with sertraline or placebo. All received Internet-based cognitive behavior therapy as non-medical treatment. Sertraline plasma concentrations were measured around pregnancy weeks 21 and 30, at delivery, 1-month postpartum, in cord blood and at 48 h of age in the infant. The clinical course of the infants was followed. Results Nine mothers and 7 infants were included in the analysis. Median dose-adjusted sertraline concentration in second trimester was 0.15(ng/mL) /(mg/day), in third trimester and at delivery 0.19 and 1-month postpartum 0.25, with a 67% relative difference between second trimester and postpartum. The interindividual variation was 10-fold. Median concentrations in the infants were 33% and 25% of their mothers’, measured in cord blood, and infant plasma, respectively. Only mild and transient adverse effects were seen on the infants. Conclusion Placental passage of sertraline to the infant is low. However, the interindividual variation in maternal concentrations during pregnancy is huge, why therapeutic drug monitoring might assist in finding the poor metabolizers at risk for adversity and increase the safety of the treatment. Trial registration The trial was registered at clinicaltrials.gov July 9, 2014 with TRN: NCT02185547.

The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Murat Akbas ◽  
Faik Mumtaz Koyuncu ◽  
Burcu Artunç-Ülkümen ◽  
Gökce Akbas
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Value Added ◽  
Shear Wave Elastography ◽  
Multiple Regression Model ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Second Trimester ◽  
The Mean ◽  
Random Measurements

AbstractObjectivesIncreased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes.MethodsA total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes.ResultsSecond-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043).ConclusionsOur results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight.

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