SERUM CONJUGATED BILE-ACID PROFILE DURING INH INTRAHEPATIC CHOLESTASIS OF PREGNANCY

Background/Aims: Intrahepatic cholestasis of pregnancy is a specific l iver disease of pregnancy of unknown cause. The serum bile acid profil e has not been clearly described in this disease and the aim of this s tudy was to investigate the serum conjugated bile acid profile. Method s: Thirteen patients with intrahepatic cholestasis of pregnancy were s tudied. Ten patients had been treated with natural progestatin before the onset of pruritus, The glyco- and tauroconjugated bile acids were quantified by high-performance liquid chromatography and direct spectr ometric detection at 199 nm. Results: There was no difference between total bile acid concentrations measured by high-performance liquid chr omatography (43,5+/-22.6 mu M, mean+/-S.D.) or by an enzymatic procedu re (43.4+/-24.6 mu M), indicating a low concentration of free bile aci ds. Primary bile acids represented 88% of total bile acids, i.e, 72.7% for cholic acid and 15.3% for chenodeoxycholic acid, For both cholic and chenodeoxycholic acids glyco- and tauroconjugates were equivalent. Secondary bile acids represented 11.3% of total bile acids, Ursodeoxy cholic acid was identified at very low concentrations in only three sa mples. Conclusions: We conclude that in intrahepatic cholestasis of pr egnancy primary bile acids are very predominant.