Sarker Minhazur, Getrajdman Chloe, Warren Leslie, Ferrara Lauren
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System & Icahn School of Medicine at Mount Sinai, New York, NY, 1176 5 Ave 9 Floor, New York, NY 10029, USA.
Case Rep Womens Health. 2022 Jul 9;35:e00430. doi: 10.1016/j.crwh.2022.e00430. eCollection 2022 Jul.
Intrahepatic cholestasis is the most common hepatobiliary complication of pregnancy. Worsening cholestasis, measured by total bile acid levels, has been associated with an increased incidence of adverse fetal outcomes; however, maternal morbidity remains rare. This report highlights a case of severe fat-soluble vitamin deficiency suspected to be secondary to severe cholestasis. Active management with weekly vitamin supplementation and close outpatient follow-up resulted in the delivery of a 32-week healthy neonate. We propose consideration of screening for fat-soluble vitamin deficiency for patients whose pregnancy is complicated by severe cholestasis or early-onset cholestasis.
肝内胆汁淤积症是妊娠最常见的肝胆并发症。通过总胆汁酸水平衡量的胆汁淤积症恶化与不良胎儿结局的发生率增加有关；然而，母亲的发病率仍然很低。本报告重点介绍了一例疑似继发于严重胆汁淤积症的严重脂溶性维生素缺乏病例。通过每周补充维生素及密切的门诊随访进行积极管理，最终成功分娩出一名32周的健康新生儿。我们建议，对于妊娠合并严重胆汁淤积症或早发型胆汁淤积症的患者，应考虑筛查脂溶性维生素缺乏情况。
