Obstetric cholestasis can cause severe pruritus in the mother, and may lead to fetal distress and stillbirth.
Although the etiology of obstetric cholestasis is multifactorial, it includes inherited dysfunction of bile canalicular transporters. One of these is associated with elevated levels of gamma glutamyl transpeptidase (GGT) when dysfunctional.
In this study, physicians from Europe assessed the incidence of obstetric cholestasis associated with elevated GGT.
The team analyzed 81 patients with obstetric cholestasis.
|All patients responded to ursodeoxycholic acid treatment.|
|Journal of Gastroenterology and Hepatology|
Patients had pruritus and elevated serum bile acids.
Of the 81 patients, 57 were treated with ursodeoxycholic acid (URSO).
The physicians found elevated GGT at presentation in 30% of patients. This was associated with significantly higher serum levels of aspartate transaminase (AST), bilirubin and serum bile acids.
However, they determined that obstetric cholestasis presented at approximately the same gestation week in all patients.
In the patients who were not treated with URSO, liver function tests did not change from the time of diagnosis to delivery.
Patients with both elevated and normal GGT levels responded to URSO treatment. They showed a significant improvement in their AST and alanine aminotransferase levels, but serum bile acids fell significantly only in the normal GGT group.
Dr Piotr Milkiewicz's team concluded, "Elevated GGT occurs in less than one-third of patients with obstetric cholestasis".
It "is associated with greater impairment of liver function tests, but no difference in gestational age at onset".
"Treatment with URSO appears to be safe and significantly improves liver function tests in patients with obstetric cholestasis, with the exception of serum bile acids in the high GGT group".