Sensitivity and Specificity of Biochemical Tests for Diagnosis of Intrahepatic Cholestasis of Pregnancy

• Published in: Annals of hepatology Vol. 16; no. 4; pp. 569 - 573
• Main Authors: Jurate, Kondrackiene, Rimantas, Zalinkevicius, Jolanta, Sumskiene, Vladas, Gintautas, Limas, Kupcinskas
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01.07.2017
• Subjects: Adult; Alanine Transaminase - blood; Aspartate Aminotransferases - blood; Bile Acids and Salts - blood; Biomarkers - blood; Chenodeoxycholic Acid - blood; Cholestasis, Intrahepatic - blood; Cholestasis, Intrahepatic - diagnosis; Cholic Acid - blood; Clinical Enzyme Tests; Diagnostics; Female; Gastroenterology and Hepatology; Humans; Intrahepatic cholestasis; Liver Function Tests; Predictive Value of Tests; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - diagnosis; Reproducibility of Results; Retrospective Studies; Serum bile acids; Transaminases; Young Adult; Pregnancy; Serum bile acids; Diagnostics; Intrahepatic cholestasis; Transaminases
• ISSN: 1665-2681; 2659-5982
• DOI: 10.5604/01.3001.0010.0294

AbstractBackground and aimIntrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory tests used for diagnosis of intrahepatic cholestasis of pregnancy and determine more reliable cut-off values of transaminases. Material and methodsSixty one symptomatic patients with ICP and 29 healthy pregnant women were included in the retrospective analysis. ResultsICP patients had higher total bile acids (TBA) levels than healthy women (32 vs. 6; P < 0.0001) due to increase in cholic acid (CA) and chenodeoxycholic acid (CDCA). CA/CDCA ratio was significantly higher in ICP patients compared to healthy pregnant women (1.13 vs. 0.68; P < 0.00002). TBA, CA, CDCA and CA/CDCA ratio demonstrate the following sensitivity (94%, 96%, 89%, 71.9%) and specificity (63%, 63%, 59%, 79.3%, respectively) for ICP diagnosis. Lowering cut-off values for ALT (31 U/ L) and AST (30 U/L) resulted only in minimal increase of sensitivity to 92.2% vs. 90.1% for ALT and to 92.2%, vs. 90.6% for AST. ConclusionThe present study did not reveal any single specific and sensitive marker for reliable diagnosis of ICP. Establishment of lower cut-off values for transaminases activity might only minimally increase the accuracy of diagnosing ICP.