Assessment of the role of APRI index in women with intrahepatic cholestasis of pregnancy

Abstract

Introduction. Intrahepatic cholestasis of pregnancy (ICP) is a condition characterized by increased liver function tests and the presence of cutaneous pruritus. The aspartate aminotransferase to platelet ratio index (APRI) has been shown to be a useful tool in diagnosing and predicting the progression of liver cirrhosis and fibrosis. At the same time, there are few studies, which would focus on the assessment of APRI level in women with ICP. Material and Methods. In a prospective study 71 clinical cases complicated by ICP (group A) were compared to 71 cases without ICP (group B). The APRI was calculated using the formula: {(AST/upper limit of the normal values) x 100}/ number of platelets (109/L). The arithmetic means and standard deviation (M (SD)) were calculated, a t-test to compare two means was applied. Besides that, Pearson’s correlation was assessed. Results. Mean values of APRI in group A were 1.2 (1.2) compared to group B – 0.3 (0.1), 95% CI 0.61 - 1.18, p˂0.0001. By analyzing the correlation between APRI and indicators assessed in the study a negative correlation with term of pregnancy at which delivery occurred (p=0.01) and with delivery duration (p=0.01) was identified. Positive correlation was also found with the presence of meconium-stained amniotic fluid (p=0.01), caesarean section rate (p=0.01) and the amount of postpartum blood loss in women recruited in the study (p=0.01). Conclusions. The results of our study revealed the correlation between APRI value and the presence of specific conditions related to pregnancy, that may be an important step in the management of cases of ICP.