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Publication Date:
December 2007
ISSN:
1619-3997
DOI:
10.1515/JPM.2007.128

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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Aslam, Muhammad / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Brezinka, Christoph / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / Dimitrou, G. / Foulon, Walter / Grunebaum, G. E. / Harding, Jane / Hentschel, Roland / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Nishida, Hiroshi / Papp, Zoltán / Makatsariya, Alexander / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Geijn, Herman P. / Vetter, Klaus / Young, Bruce K. / Zimmermann, Roland / Köpcke, W.

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Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays

William M. Huang1 / David E. Seubert2 / James G. Donnelly3 / Mengling Liu4 / Norman B. Javitt5

1Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, New York University, New York, NY, USA

2Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, New York University, New York, NY, USA

3Department of Pathology, Chemistry, New York University, New York, NY, USA

4Department of Environmental Medicine, Biostatistics, New York University, New York, NY, USA

5Department of Internal Medicine, Gastroenterology, New York University, New York, NY, USA

Corresponding author: William M. Huang, MD NYU Medical Center Department of Obstetrics and Gynecology 550 First Ave NBV9E2 New York, NY 10016 USA Tel.: +1-646-228-4576 (Cell) Fax: +1-212-263-8251

Citation Information: Journal of Perinatal Medicine. Volume 35, Issue 6, Pages 486–491, ISSN (Online) 16193997, ISSN (Print) 03005577, DOI: 10.1515/JPM.2007.128, December 2007

Publication History:
Published Online:
2007-12-05

Abstract

Aims: To determine sensitivity and specificity of urine bile acid sulfate (UBAS) and non-sulfated urine bile acid (UBA) assays for detection of intrahepatic cholestasis of pregnancy (ICP).

Methods: Urine was collected prospectively from healthy and pruritic patients evaluated for ICP. Results were expressed as a ratio to urinary creatinine.

Results: Of 20 patients evaluated for ICP, 14 had confirmed ICP by serum testing and six had pruritus only. UBAS results were higher with ICP (P<0.001) and increased with gestational age in healthy controls. Adjusted for gestational age, the multiples of the median (MoM) were still higher (2.64±1.11, 1.05±0.54, P<0.001). The sensitivity was 100% and specificity 83% at 1.5 MoM in pruritic patients. UBA results were higher with ICP (23.0±9.8, 12.8±7.4, P<0.001), with sensitivity of 100% and specificity of 50% at 10.2 μmol/g cretinine.

Conclusion: Urinary bile acids can detect or exclude ICP with serum abnormalities. Urine bile acid sulfates have higher specificity than non-sulfated urine bile acids at equivalent sensitivities, but co-detection of progestin sulfates is suspected.

Keywords: Bile acid; bile acid sulfate; cholestasis of pregnancy; diagnosis; sensitivity and specificity; urine

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