Intrahepatic cholestasis of pregnancy: Is fetoplacental doppler ultrasound useful in the diagnosis and follow-up?

Aim: In this study, we aimed to examine whether Doppler ultrasonography (USG) is an important diagnostic tool for fetal follow-up in case of obstetric cholestasis. Material and Methods: This study included 50 patients diagnosed with obstetric cholestasis and 39 pregnant women turning up for their regular pregnancy follow-up. Pregnants were diagnosed according to definition, symptoms, and laboratory findings. Biochemical tests, bile acid test, upper abdominal USG, Non-Stress Test (NST), obstetric USG, amniotic fluid test, and fetoplacental Doppler USG were performed on all patients. Systole/Diastole (S/D) ratio of Umbilical artery (UA) and Middle cerebral artery (MCA)s, delivery types of patients, weight at birth, Apgar scores, and the existence of meconium were separately recorded. Results: The mean age of the patients with obstetric cholestasis was 26.6 years, while in the control group it was 25.1 years (p = 0.176). No statistical difference was identified with regard to the average of (UA and MCA)/(S/D) ratio of both patient groups. In terms of delivery type, patients' UA and MCA S/D ratio averages were not statistically significant. There was no statistical link between cholestasis story in previous pregnancies, cholestasis in the current pregnancy, bile acid, and high ALP and baby's gender. Discussion: Intrahepatic cholestasis of pregnancy is also a reversible form of cholestasis and it usually emerges in the late pregnancy period and continues until birth. In this study, it was detected that fetoplacental Doppler USG, which is used as a diagnostic tool for obstetric cholestasis, has a low level of predictivity. During our study, Doppler USG use in obstetric cholestasis diagnosis and follow-up was not effective.