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Fibrinogen Levels and Total Serum Bile Acids in Intrahepatic Cholestasis of Pregnancy

Levent Ozgen¹, Gulten Ozgen², Suleyman Serkan Karasin²

¹Department of Gynecological Oncology Surgery, Faculty of Medicine, Uludag University, Bursa, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|November 15, 2022

Abstract

Objective:

To determine the role of complete blood count and coagulation function factors as inflammatory markers in intrahepatic cholestasis of pregnancy (ICP).

Study Design:

Descriptive, analytical study.

Place And Duration Of Study:

Department of Obstetrics and Gynecology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey, between January 2018 and 2021.

Methodology:

This study was conducted with a total of 200 pregnant women, 80 with ICP and 120 control healthy pregnant women. The diagnosis of ICP was made based on elevated liver enzymes and bile acids (≥10 μmol/L) and pruritis. Routine complete blood count parameters and coagulation function tests were compared between both groups. ROC analyses were used to analyse the predictive value of fibrinogen levels in ICP. Spearman's rank correlation analysis assessed the correlation between fasting bile acid value and complete blood count and coagulation parameters.

Results:

Neutrophil-lymphocyte ratio (NLR), Platelet count, and Platecrit levels were significantly higher in the ICP group, and red blood cell distribution width (RDW) was lower than in the healthy group (p <0.05). The median plasma fibrinogen value was 571 mg/dl which was significantly higher in pregnant women with cholestasis (p <0.001). The prothrombin time and international normalized ratio (INR) values were also significantly different in each group (p <0.001 and 0.013, respectively). In addition, platelet distribution width (PDW), plasma fibrinogen, and prothrombin time (PT) showed significant association with the bile acid values (p values=0.007, 0.03, and 0.04 respectively). Each 1-unit elevation of the fibrinogen increased the risk of cholestasis by 1.02 times. There was a positive correlation of 0.24-fold between the plasma fibrinogen value and acids.

Conclusion:

The plasma fibrinogen value was the highest predictor of cholestasis diagnosis by analyzing blood parameters. Elevated fibrinogen levels correlated with bile acid levels, can potentially detect ICP.

Key Words:

Bile acids, Cholestasis, Coagulation function parameters, Fibrinogen levels, Inflammation.

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