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Abstract
Objectives. This study was designed for evaluating coagulation parameters and low APGAR scores in pregnancies with intrahepatic cholestasis of pregnancy (ICP) vs. normal control pregnancies.
Methods. We carried out a prospective case–control study by enrolling 40 women with ICP at the third trimester of pregnancy and 40 pregnant women without ICP.
Results. Total bile acid levels (TBA), MPV, D-dimer, and umbilical artery systolic/diastolic ratio (UASDR) values were higher in women with ICP. Pregnancies complicated by low APGAR score exhibited significantly higher D-dimer levels than those of unimpaired fetal outcome in patients with ICP and control subjects. Levels of D-dimer were inversely correlated with 5′-Apgar score and positively associated with UASDR values in patients with ICP. Pregnancies that exhibited abnormal UASDR had higher total bile acid (TBA), D-dimer, MPV values and lesser 5′-Apgar score. In linear stepwise regression analyses, D-dimer independently and positively associated with UASDR, inversely associated with 5′-Apgar score in subjects with ICP; positively associated with mean platelet volume (MPV) values and inversely associated with 5′-Apgar score in all subjects.
Conclusion. Patients with ICP had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, and also D-dimer is associated with lower APGAR scores in both ICP and all pregnancies. Increased D-dimer levels suggest that hematological parameters could be potentially used as indicators of risk factor for assessing low APGAR score in ICP.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.