Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review
Abstract Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-023-02471-4 |
| _version_ | 1797801253238996992 |
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| author | Loris Marin Guido Ambrosini Ludovica Nuzzi Giovanni Buzzaccarini Federica Esposito Giampiero Capobianco Vito Chiantera Antonio Simone Laganà Alessandra Andrisani |
| author_facet | Loris Marin Guido Ambrosini Ludovica Nuzzi Giovanni Buzzaccarini Federica Esposito Giampiero Capobianco Vito Chiantera Antonio Simone Laganà Alessandra Andrisani |
| author_sort | Loris Marin |
| collection | DOAJ |
| description | Abstract Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective of this article is to report one of these rare cases and offer an overview of the other published cases. Case presentation We report a case of severe OHSS followed by ICP in the first trimester. The patient was admitted to the intensive care unit and was treated according to the guidelines for the management of OHSS. Moreover, the patient also received ursodeoxycholic acid for ICP, which brought to an improvement of her clinical conditions. The pregnancy continued without other complications until the 36th week of gestation, when the patient developed ICP in the third trimester and underwent cesarean section for increased bile acid levels and cardiotocographic (CTG) pathologic alterations. The newborn was a healthy baby weighing 2500 gr. We also reviewed other case reports published by other authors about this clinical condition. We present what is, to our knowledge, the first case of ICP developed in the first trimester of pregnancy after OHSS in which genetic polymorphisms of ABCB4 (MDR3) have been investigated. Conclusions ICP in the first trimester might be induced by elevated serum estrogen levels after OHSS in genetically predisposed women. In these women, it might be useful to check for genetic polymorphisms to know if they have a predisposition for ICP recurrence in the third trimester of pregnancy. |
| first_indexed | 2024-03-13T04:47:38Z |
| format | Article |
| id | doaj.art-99d1db5799874954aa054933165f5075 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-03-13T04:47:38Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-99d1db5799874954aa054933165f50752023-06-18T11:23:54ZengBMCBMC Women's Health1472-68742023-06-012311710.1186/s12905-023-02471-4Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature reviewLoris Marin0Guido Ambrosini1Ludovica Nuzzi2Giovanni Buzzaccarini3Federica Esposito4Giampiero Capobianco5Vito Chiantera6Antonio Simone Laganà7Alessandra Andrisani8Department of Women’s and Children’s Health, University of PaduaDepartment of Women’s and Children’s Health, University of PaduaDepartment of Women’s and Children’s Health, University of PaduaObstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityDepartment of Women’s and Children’s Health, University of PaduaDepartment of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of SassariUnit of Gynecologic Oncology, ARNAS “Civico – Di Cristina – Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of PalermoUnit of Gynecologic Oncology, ARNAS “Civico – Di Cristina – Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of PalermoDepartment of Women’s and Children’s Health, University of PaduaAbstract Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective of this article is to report one of these rare cases and offer an overview of the other published cases. Case presentation We report a case of severe OHSS followed by ICP in the first trimester. The patient was admitted to the intensive care unit and was treated according to the guidelines for the management of OHSS. Moreover, the patient also received ursodeoxycholic acid for ICP, which brought to an improvement of her clinical conditions. The pregnancy continued without other complications until the 36th week of gestation, when the patient developed ICP in the third trimester and underwent cesarean section for increased bile acid levels and cardiotocographic (CTG) pathologic alterations. The newborn was a healthy baby weighing 2500 gr. We also reviewed other case reports published by other authors about this clinical condition. We present what is, to our knowledge, the first case of ICP developed in the first trimester of pregnancy after OHSS in which genetic polymorphisms of ABCB4 (MDR3) have been investigated. Conclusions ICP in the first trimester might be induced by elevated serum estrogen levels after OHSS in genetically predisposed women. In these women, it might be useful to check for genetic polymorphisms to know if they have a predisposition for ICP recurrence in the third trimester of pregnancy.https://doi.org/10.1186/s12905-023-02471-4Intrahepatic cholestasis of pregnancyFirst trimesterOvarian hyperstimulation syndromeIn vitro fertilizationGenetic polymorphisms |
| spellingShingle | Loris Marin Guido Ambrosini Ludovica Nuzzi Giovanni Buzzaccarini Federica Esposito Giampiero Capobianco Vito Chiantera Antonio Simone Laganà Alessandra Andrisani Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review BMC Women's Health Intrahepatic cholestasis of pregnancy First trimester Ovarian hyperstimulation syndrome In vitro fertilization Genetic polymorphisms |
| title | Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review |
| title_full | Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review |
| title_fullStr | Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review |
| title_full_unstemmed | Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review |
| title_short | Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review |
| title_sort | intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild type abcb4 gene a peculiar case and literature review |
| topic | Intrahepatic cholestasis of pregnancy First trimester Ovarian hyperstimulation syndrome In vitro fertilization Genetic polymorphisms |
| url | https://doi.org/10.1186/s12905-023-02471-4 |
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