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

Authors : Neval Çayönü Kahraman, Zeynep Şeyhanlı, Gülşan Karabay, Özgür Arat, Kadriye Yakut Yücel, Şevki Çelen, Ali Turhan Çağlar, Yaprak Engin Üstün
Pages : 946-951
Doi:10.32322/jhsm.1758040
View : 92 | Download : 107
Publication Date : 2025-09-16
Article Type : Research Paper
Abstract :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 (p<0.001). 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 (p=0.005), 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.
Keywords : İntrahepatik Kolestaz, Fetal Kalp, Miyokardiyal Performans İndeksi, Epikardiyal Yağ Dokusu, Safra Asitleri

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