Effect of a standard test meal on serum bile acid levels in healthy nonpregnant and pregnant women and in patients with intrahepatic cholestasis of pregnancy.

Eight healthy nonpregnant women, nine pregnant women, and eight patients with intrahepatic cholestasis (IHC) of pregnancy were investigated. Serum samples were collected after overnight fasting just before the application of the test meal and 30, 60, 120 and 180 min afterwards for determination of serum cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) concentrations by radioimmunoassays. After the test meal primary bile acid levels were increased significantly (p less than 0.01) in every group after one hour and CDCA concentrations increased to a greater extent and more rapidly than those of CA. In pregnant women there were two cases with increased CA levels after three hours. In patients with IHC of pregnancy CA concentrations after three hours were higher than the initial fasting levels in every case and also over the normal reference limit. The testing of liver function by measuring the serum concentrations of endogenous bile acids after the test meal seems to be useful and more sensitive than measuring the levels of fasting bile acids in the mild forms of IHC of pregnancy. Normal pregnancy also appears to result in a somewhat cholestatic condition.