Prospective case-control study reveals prolonged fetal PR intervals in intrahepatic cholestasis of pregnancy, suggesting bile acid-induced conduction slowing that improves with ursodeoxycholic acid.
OBJECTIVE: This study had three purposes: first, to explore differences in fetal cardiac function in patients with and without intrahepatic cholestasis of pregnancy (ICP) based on PR interval (the interval between the beginning of the atrial contraction and the beginning of the ventricular contraction). Second, to explore a potential correlation between PR interval and bile acid levels in pregnant women with ICP. Third, to study changes in PR interval of fetuses from pregnant women with ICP after administration of ursodeoxycholic acid (UDCA). STUDY DESIGN: This was a prospective observational case-control study. ICP was defined as palmar plantar pruritus of nocturnal predominance for more than 1 week associated with a total bile acid level >10 μmol/L. Control cases were women with pregnancies scheduled for induction or elective cesarean section at term. RESULTS: = 0.004). CONCLUSION: PR interval is longer in fetuses of women with ICP. PR interval was significantly correlated with bile acid levels, and administration of UDCA significantly reduced PR interval. KEY POINTS: · Differences in fetal cardiac function in patients with and without intrahepatic cholestasis.. · PR interval and bile acid levels in pregnant women with intrahepatic cholestasis.. · Changes in PR interval of fetuses from pregnant women with ICP after use of UDCA..
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Hernández‐Guerra et al. (2023) studied this question.
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