The mechanical PR interval in fetuses of women with intrahepatic cholestasis of pregnancy

Am J Obstet Gynecol. 2010 Nov;203(5):455.e1-5. doi: 10.1016/j.ajog.2010.05.035. Epub 2010 Aug 3.


Objective: The purpose of this study was to evaluate the fetal mechanical PR interval in intrahepatic cholestasis of pregnancy (ICP).

Study design: Fetal echocardiography was performed for women with ICP and control subjects. Clinical characteristics, total bile acids, and liver profile tests were compared between groups.

Results: Fourteen women with ICP and 7 control subjects were enrolled. Total bile acids (28.3 vs 6.2 μmol/L; P < .001), aspartate aminotransferase (53 vs 23 IU/L; P = .002), alanine aminotransferase (63 vs 19 IU/L; P = .002), and the PR interval (124 vs 110 msec; P = .006) were significantly higher in fetuses with ICP than in control fetuses. On multivariable linear regression analysis, only the presence of ICP was associated significantly with an increase in the PR interval (95% confidence interval, 4-24 msec; P = .01).

Conclusion: The fetal cardiac conduction system is altered in ICP. Further investigation is needed to determine whether fetal echocardiography can help to predict which fetuses are at risk for death that is associated with ICP.

MeSH terms

  • Adult
  • Cholestasis, Intrahepatic / diagnostic imaging*
  • Female
  • Heart Conduction System / diagnostic imaging*
  • Humans
  • Linear Models
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging*
  • Ultrasonography, Prenatal