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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 / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays

William M. Huang
  • 1Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, New York University, New York, NY, USA
/ David E. Seubert
  • 2Department of Obstetrics and Gynecology, Maternal-Fetal Medicine, New York University, New York, NY, USA
/ James G. Donnelly
  • 3Department of Pathology, Chemistry, New York University, New York, NY, USA
/ Mengling Liu
  • 4Department of Environmental Medicine, Biostatistics, New York University, New York, NY, USA
/ Norman B. Javitt
  • 5Department of Internal Medicine, Gastroenterology, New York University, New York, NY, USA
Published Online: 2007-12-05 | DOI: https://doi.org/10.1515/JPM.2007.128


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

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

Published Online: 2007-12-05

Published in Print: 2007-12-01

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

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