Bile Acid Profile Of Umbilical Cord Of Intrahepatic Cholestasis Of Pregnancy By High Performance Liquid Chromatography And Pregnant Outcome

Objective To investigate the differences of liver function of pregnant women, the bile acids profile of umbilical cord blood and pregnant outcome under different grading standards of intrahepatic cholestasis of pregnancy (ICP).Methods Bile acids profiles of umbilical cord blood of intrahepatic cholestasis of pregnancy were analyzed by high performance liquid chromatography. Eight kinds of bile acids including tauroursodeoxycholic acid (TUDCA), taurocholic acid (TCA), glycocholic acid(GCA), glycolithocholic acid(GLCA), taurochenodeoxycholic acid(TCDCA), taurodeoxycholic acid(TDCA), glycochenodeoxycholic acid (GCDCA), glycodeoxycholicacid (GDCA) were involved in the study. Maternal liver function, bile acids profiles of umbilical cord blood and pregnant outcomes were analyzed under four kinds of ICP grading standard.Results (1) When compared with normal pregnancy group and mild ICP group, there were statistically significant differences of ALT, AST, TBIL, DBIL under the third ICP grading standard and the fourth standard (P <0.05), there were statistically significant differences of TCA, GCA under the four standards (P <0.05), there were significant difference of GLCA under the first standard and the second standard (P <0.05), there were significantly differences of GCDCA under the fourth standard (P <0.05), there was significantly difference of the morbidity of premature infant under the third standard (P <0.05).(2) When compared with normal pregnancy group and severe ICP group, there were significant differences of ALT, AST, TBIL, DBIL with under four standards (P <0.05), there were significant differences of TCA, GCA, GLCA, TCDCA under four standards (P <0.05), there were significant differences of GCDCA under the first standard ,the second standard and the fourth standard (P<0.05), there were significant differences of the morbidity of premature infant and meconium staining of amniotic fluid under the first standard, the second standard and the fourth standard (P <0.05).(3) When compared with mild ICP group and severe ICP group, there were significant differences of ALT, AST, TBIL, DBIL under the first standard and the second standard (P <0.05), there were significant differences of TCA, TCDCA under four standards (P <0.05), there were significantly difference of GCDCA under the first standard(P <0.05), there were significantly difference of GLCA under the fourth standard(P <0.05), there were significant difference of the morbidity of pr emature infant under the first standard (P <0.05).Conclusion The ICP grading standard reflects the differences of liver function of pregnant women with ICP. Tauro-conjugated and glyco-conjugated bile acids are the predominant increase in serum bile acids of cord blood,and the concentration of tauro-conjugated bile acid are higher than that of glyco-conjugated. TCA, TCDCA and GLCA are significant higher in the severe ICP group than the mild ICP group. The morbidity of premature infant and meconium staining of amniotic fluid are significant higher in the severe ICP group than the mild ICP group.