Assessment of fetal cardiac function and epicardial fat thickness in intrahepatic cholestasis pregnancies

Neval Çayönü Kahraman; Zeynep Şeyhanlı; Gülşan Karabay; Özgür Arat; Kadriye Yakut Yücel; Şevki Çelen; Ali Turhan Çağlar; Yaprak Engin Üstün

Makale detayları

Assessment of fetal cardiac function and epicardial fat thickness in intrahepatic cholestasis pregnancies

Yazarlar:

Neval Çayönü Kahraman | Zeynep Şeyhanlı | Gülşan Karabay | Özgür Arat | Kadriye Yakut Yücel | Şevki Çelen | Ali Turhan Çağlar | Yaprak Engin Üstün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Gastroenteroloji ve Hepatoloji | Kadın Hastalıkları ve Doğum

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.946-951

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358401

pISSN:

2636-8579

Anahtar kelimeler:

Özet:

 Aims: This study is to evaluate fetal cardiac activity and epicardial fat thickness EFT in pregnant women with intrahepatic cholestasis IHCP and to investigate the relationship between these measurements and perinatal outcomes. Methods: This prospective case-control study was conducted between May 2022 and October 2024 at a tertiary perinatology clinic. The study group comprised 38 women with IHCP, and the control group included 39 healthy pregnancies matched for gestational age and maternal characteristics. Fetal cardiac function was evaluated by echocardiographic parameters including the Myocardial Performance Index MPI, isovolumic contraction time ICT, ejection time ET, and PR interval, and EFT was quantified in the four-chamber view. Doppler indices of the umbilical, middle cerebral, and uterine arteries, along with neonatal outcomes such as gestational age, birth weight, APGAR scores, and neonatal intensive care unit NICU admission, were recorded. Results: In the IHCP cohort, bile acid, aspartate aminotransferase AST, and alanine aminotransferase ALT levels were significantly elevated p0.001. MPI, ICT, ET, and PR interval values were also increased, indicating subclinical effects on fetal cardiac function. No significant differences were detected in EFT between groups. Gestational age at birth was lower in the IHCP group p0.005, and NICU admission was clinically higher, though not statistically significant. Conclusion: IHCP may impair fetal cardiac conduction and contractility, with these alterations positively associated with serum bile acid concentrations. EFT seems more closely linked to chronic metabolic stress than to acute conditions. Regular echocardiographic monitoring may aid in safeguarding fetal well-being.

 Aims: This study is to evaluate fetal cardiac activity and epicardial fat thickness EFT in pregnant women with intrahepatic cholestasis IHCP and to investigate the relationship between these measurements and perinatal outcomes. Methods: This prospective case-control study was conducted between May 2022 and October 2024 at a tertiary perinatology clinic. The study group comprised 38 women with IHCP, and the control group included 39 healthy pregnancies matched for gestational age and maternal characteristics. Fetal cardiac function was evaluated by echocardiographic parameters including the Myocardial Performance Index MPI, isovolumic contraction time ICT, ejection time ET, and PR interval, and EFT was quantified in the four-chamber view. Doppler indices of the umbilical, middle cerebral, and uterine arteries, along with neonatal outcomes such as gestational age, birth weight, APGAR scores, and neonatal intensive care unit NICU admission, were recorded. Results: In the IHCP cohort, bile acid, aspartate aminotransferase AST, and alanine aminotransferase ALT levels were significantly elevated p0.001. MPI, ICT, ET, and PR interval values were also increased, indicating subclinical effects on fetal cardiac function. No significant differences were detected in EFT between groups. Gestational age at birth was lower in the IHCP group p0.005, and NICU admission was clinically higher, though not statistically significant. Conclusion: IHCP may impair fetal cardiac conduction and contractility, with these alterations positively associated with serum bile acid concentrations. EFT seems more closely linked to chronic metabolic stress than to acute conditions. Regular echocardiographic monitoring may aid in safeguarding fetal well-being.

 Aims: This study is to evaluate fetal cardiac activity and epicardial fat thickness EFT in pregnant women with intrahepatic cholestasis IHCP and to investigate the relationship between these measurements and perinatal outcomes. Methods: This prospective case-control study was conducted between May 2022 and October 2024 at a tertiary perinatology clinic. The study group comprised 38 women with IHCP, and the control group included 39 healthy pregnancies matched for gestational age and maternal characteristics. Fetal cardiac function was evaluated by echocardiographic parameters including the Myocardial Performance Index MPI, isovolumic contraction time ICT, ejection time ET, and PR interval, and EFT was quantified in the four-chamber view. Doppler indices of the umbilical, middle cerebral, and uterine arteries, along with neonatal outcomes such as gestational age, birth weight, APGAR scores, and neonatal intensive care unit NICU admission, were recorded. Results: In the IHCP cohort, bile acid, aspartate aminotransferase AST, and alanine aminotransferase ALT levels were significantly elevated p0.001. MPI, ICT, ET, and PR interval values were also increased, indicating subclinical effects on fetal cardiac function. No significant differences were detected in EFT between groups. Gestational age at birth was lower in the IHCP group p0.005, and NICU admission was clinically higher, though not statistically significant. Conclusion: IHCP may impair fetal cardiac conduction and contractility, with these alterations positively associated with serum bile acid concentrations. EFT seems more closely linked to chronic metabolic stress than to acute conditions. Regular echocardiographic monitoring may aid in safeguarding fetal well-being.

 Amaç: Bu çalışma, intrahepatik kolestaz İHK tanısı konulan gebelerde fetal kardiyak aktiviteyi ve epikardiyal yağ dokusu EFT kalınlığını değerlendirmeyi ve bu parametrelerin perinatal sonuçlarla olan ilişkisini araştırmayı amaçlamaktadır. Yöntem: Bu prospektif olgu-kontrol çalışması, Mayıs 2022 ile Ekim 2024 tarihleri arasında bir üçüncü basamak perinatoloji kliniğinde gerçekleştirilmiştir. Çalışma grubunu İHK tanısı konulan 38 gebe oluştururken, kontrol grubunu gestasyonel yaş ve maternal özellikler açısından eşleştirilmiş 39 sağlıklı gebe oluşturmuştur. Fetal kardiyak fonksiyon, ekokardiyografik parametrelerle MPI, ICT, ET, PR aralığı değerlendirilmiş ve EFT dört boşluk görüntüsünde ölçülmüştür. Umbilikal arter, orta serebral arter ve uterin arter Doppler indeksleri ile birlikte yenidoğan sonuçları doğum haftası, doğum ağırlığı, APGAR skorları ve YDYB kabulü kaydedilmiştir. Bulgular: İHK grubunda safra asidi, AST ve ALT düzeyleri anlamlı şekilde artmıştı p0.001. MPI, ICT, ET ve PR aralığı değerlerinde belirgin artış gözlenmiş olup, bu durum embriyonal kalp fonksiyonlarında subklinik etkilenmeyi düşündürmektedir. Gruplar arasında EFT düzeylerinde anlamlı bir fark saptanmamıştır. Doğum haftası İHK grubunda daha erken gerçekleşmiştir p0.005 ve yenidoğan yoğun bakım gereksinimi klinik olarak artmış olsa da istatistiksel olarak anlamlı bulunmamıştır. Sonuç: İHK, fetal kardiyak iletim ve kontraksiyon mekanizmaları üzerinde olumsuz etkilere yol açabilir. Bu değişiklikler, serum safra asidi düzeyleriyle pozitif ilişki göstermektedir. EFT, akut durumlardan çok kronik metabolik stresle ilişkili görünmektedir. Zamanında yapılan ekokardiyografik takip, fetal iyilik halinin korunmasında faydalı olabilir.

Makale detayları

Assessment of fetal cardiac function and epicardial fat thickness in intrahepatic cholestasis pregnancies

Yazarlar:

Neval Çayönü Kahraman | Zeynep Şeyhanlı | Gülşan Karabay | Özgür Arat | Kadriye Yakut Yücel | Şevki Çelen | Ali Turhan Çağlar | Yaprak Engin Üstün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Gastroenteroloji ve Hepatoloji | Kadın Hastalıkları ve Doğum

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.946-951

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358401

pISSN:

2636-8579

Cholestasis

intrahepatic

fetal heart

Myocardial Performance Index

epicardial fat

bile acidsİntrahepatik Kolestaz

Fetal Kalp

Miyokardiyal Performans İndeksi

Epikardiyal Yağ Dokusu

Safra Asitleri

Sayı

Makale detayları

Yazarlar: Neval Çayönü Kahraman | Zeynep Şeyhanlı | Gülşan Karabay | Özgür Arat | Kadriye Yakut Yücel | Şevki Çelen | Ali Turhan Çağlar | Yaprak Engin Üstün

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Gastroenteroloji ve Hepatoloji | Kadın Hastalıkları ve Doğum

Dergi: Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.946-951

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001358401

pISSN: 2636-8579

Sayı

Yazarlar:

Neval Çayönü Kahraman | Zeynep Şeyhanlı | Gülşan Karabay | Özgür Arat | Kadriye Yakut Yücel | Şevki Çelen | Ali Turhan Çağlar | Yaprak Engin Üstün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Gastroenteroloji ve Hepatoloji | Kadın Hastalıkları ve Doğum

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.946-951

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358401

pISSN:

2636-8579