MANAGEMENT OF PREGNANCY IN WOMEN WITH INFERTILITY IN CASE OF CONCOMITANT INTRAHEPATIC CHOLESTASIS
DOI:
https://doi.org/10.11603/24116-4944.2020.1.11488Keywords:
pregnancy, infertility, intrahepatic cholestasisAbstract
The aim of the study – to examine the features of pregnancy and the condition of newborns in women with infertility after the use of assisted reproductive technologies.
Materials and Methods. We analyzed 260 outpatient records of women treated for infertility with the use of an ART program (in vitro fertilization). 56 out 260 women (21.8 %) got pregnant (basic group). The reference group consisted of 30 women who got pregnant without the use of ART.
Results and Discussion. Diseases of liver and biliary ducts are important extragenital pathologies in pregnant women and quite often contribute to the development of obstetric pathologies. In their turn, pregnancies achieved with the use of assisted reproductive technologies, under a massive hormonal support, may lead to severe irreversible changes in the hepatobiliary system. Our retrospective analysis established that pregnancy after the use of ART in women with intrahepatic cholestasis has the following peculiarities: a significantly higher frequency of miscarriages and missed miscarriages, threats of preterm labor, early gestosis, severe preeclampsia and intrauterine growth restriction. Almost 40 % of the newborns presented asphyxia at birth, 11.1 % a severe one, a third of the babies were born prematurely and 40 % presented signs of hypotrophy, while 66.7 % had a disturbed course of early neonatal adaptation. The percentage of perinatal mortality was also higher.
Conclusions. The issues of etiology, pathogenesis, the risk factors determining the development of intrahepatic cholestasis, the principles of treatment and prevention still remain the subject of discussion and their specific mechanisms require a more detailed research to develop a pathogenetically substantiated system of treatment and prevention measures.
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