Key result
Intrahepatic cholestasis of pregnancy is linked to a higher fetal pulmonary artery acceleration-to-ejection time ratio.
Why the study?
Intrahepatic cholestasis of pregnancy is associated with higher incidence of adverse pregnancy outcomes, but changes in foetal pulmonary artery Doppler parameters in ICP pregnancies compared to normal pregnancies are not well characterized.
Does foetal pulmonary artery Doppler evaluation detect altered pulmonary hemodynamics in pregnancies complicated by intrahepatic cholestasis compared to normal pregnancies?
Case-Control (n=100)
No
Does foetal pulmonary artery Doppler evaluation detect altered pulmonary hemodynamics in pregnancies complicated by intrahepatic cholestasis compared to normal pregnancies?
Absolute Event Rate: 0.28% vs 0.17%
p-value: p=0.0001
Intrahepatic cholestasis of pregnancy is associated with significantly altered foetal pulmonary hemodynamics and an increased risk of neonatal respiratory distress syndrome.
Altered fetal pulmonary Doppler in intrahepatic cholestasis may signal hemodynamic changes; extends prior observations but leaves clinical utility open.
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is the most prevalent liver disease specific to pregnancy, with higher incidence of adverse pregnancy outcomes. Keeping this in mind, this study has been framed to compare the changes in foetal pulmonary artery Doppler in pregnancies complicated with ICP with normal pregnancies. MATERIALS AND METHODS: This prospective study included total of 100 patients as per the inclusion and exclusion criteria. These patients were divided into two groups: the case group (ICP pregnancies) and control group (normal pregnancies). The Doppler parameters were analysed in terms of acceleration time/ejection time (AT/ET) ratio and the maternal and foetal outcome were evaluated. RESULTS: Significant differences were found in Doppler parameters between the groups, with longer acceleration times (AT), shorter ejection times (ET), and higher PATET ratios in the ICP cases, which signify altered right ventricular outflow parameters, suggesting compromised pulmonary hemodynamics in newborns of ICP-affected pregnancies. These parameters were significantly influenced by the severity of ICP. The AT and ET, which are measures of cardiac function, show weak correlations with the liver function markers (all below 0.23), suggesting minimal direct relationships between these cardiac parameters and liver dysfunction in ICP patients. CONCLUSION: The altered Doppler parameters reflect changes in foetal pulmonary vascular resistance and could be indicative of lung immaturity or altered hemodynamics secondary to the toxic effects of elevated maternal bile acid levels.
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Fatima et al. (2026) conducted a case-control in Intrahepatic cholestasis of pregnancy (n=100). Intrahepatic cholestasis of pregnancy vs. Normal pregnancies was evaluated on Ratio of Acceleration and Ejection time (PATET) of fetal pulmonary artery (p=0.0001). Intrahepatic cholestasis of pregnancy was associated with a significantly higher fetal pulmonary artery acceleration/ejection time ratio compared to normal pregnancies (0.28 vs 0.17, p=0.0001).
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