Harrington Laura, Ovadia Caroline, Heneghan Michael, Williamson Catherine
Acute Internal Medicine, 11F Royal London Hospital, London, UK.
Department of Women's & Children's Health, King's College London, London, UK.
Obstet Med. 2024 Dec 25:1753495X241293324. doi: 10.1177/1753495X241293324.
This primigravid pregnant woman had a new diagnosis of primary biliary cholangitis (PBC) that was treated with a combination of ursodeoxycholic acid (UDCA) and bezafibrate. Pregnancy may unmask underlying chronic hepatic disorders in susceptible women and, in some cases, the associated abnormalities of liver function or increased serum bile acids (hypercholanaemia) can result in significant fetal and maternal risk. Maternal pruritus, with associated sleep deprivation, may cause considerable distress. To our knowledge, this is the first reported case of a new diagnosis of PBC in pregnancy treated with a combination of both UDCA and a fibrate. The case demonstrates the importance of accurate and efficient diagnosis alongside effective multidisciplinary team working to initiate appropriate, timely treatment to minimise the risk to fetus and mother. Early assessment, risk stratification and cautious surveillance is paramount in managing evolving or coexisting pathology plus individualised delivery planning, aiming to optimise fetal and maternal outcomes.
这位初产妇被新诊断为原发性胆汁性胆管炎（PBC），接受了熊去氧胆酸（UDCA）和苯扎贝特联合治疗。怀孕可能会使易感女性潜在的慢性肝脏疾病显现出来，在某些情况下，相关的肝功能异常或血清胆汁酸升高（高胆酸血症）会给胎儿和母亲带来重大风险。孕妇瘙痒并伴有睡眠不足，可能会造成相当大的困扰。据我们所知，这是首例报告的在孕期新诊断为PBC且接受UDCA和贝特类药物联合治疗的病例。该病例表明，准确有效的诊断以及多学科团队的有效协作对于启动适当、及时的治疗以降低对胎儿和母亲的风险至关重要。早期评估、风险分层和谨慎监测对于处理不断演变或并存的病理状况以及个性化分娩计划至关重要，旨在优化胎儿和母亲的结局。
