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Morbidity High in Intrahepatic Cholestasis of Pregnancy

Higher gastrointestinal permeability, higher risk of liver and biliary diseases

THURSDAY, April 6 (HealthDay News) -- Women with intrahepatic cholestasis of pregnancy have increased gastrointestinal permeability and are at higher risk of developing liver and biliary diseases, according to two studies published in the April issue of Hepatology.

In the first study, Humberto Reyes, M.D., and colleagues from the Universidad de Chile in Santiago, examined gastrointestinal permeability and levels of anti-lipopolysaccharide and four cytokines in plasma in 20 women with intrahepatic cholestasis of pregnancy, 22 normal pregnant women, and 29 non-pregnant women. They found that gastrointestinal permeability, as assessed by the urinary lactulose/mannitol ratio after a standard oral load, was significantly higher in women with intrahepatic cholestasis of pregnancy.

In the second study, Anne Ropponen, M.D., from Helsinki University Central Hospital in Finland, and colleagues assessed the risk of liver and biliary diseases in 10,504 women who had a history of intrahepatic cholestasis of pregnancy and an equivalent number of matched women with normal pregnancies. The researchers found that women with intrahepatic cholestasis of pregnancy had significantly higher rates of hepatitis C, nonalcoholic liver cirrhosis, gallstones and cholecystitis, and nonalcoholic pancreatitis.

"The studies...support the notion that intrahepatic cholestasis of pregnancy represents a pregnancy-related cholestatic syndrome with a heterogeneous pathogenetic background," Ulrich Beuers, M.D., and Thomas Pusl of the University of Munich in Germany, comment in an accompanying editorial.

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