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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(01): e16-e18
DOI: 10.1055/s-0043-1777999
Original Article

Intrahepatic Cholestasis of Pregnancy and Transaminitis in Women with COVID-19: A Case Series

Anne R. Waldrop 
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Andrea Henkel 
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Kelley B. Lee
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Maurice L. Druzin
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Natali Aziz
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Yasser El-Sayed
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Deirdre J. Lyell
1   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
› Author Affiliations Funding None.
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Abstract

Objective The four initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant women presenting at term gestation to our institution presented with transaminitis. Three of the four were diagnosed with intrahepatic cholestasis of pregnancy (IHCP). Growing evidence exists of an associated transaminitis in nonpregnant SARS-CoV-2 patients. However, there are limited data of hepatic involvement of SARS-CoV-2 in pregnancy, and no previous studies have assessed the association with IHCP in patients with coronavirus disease 2019 (COVID-19).

Study Design This was a retrospective, single-center case series of four consecutive pregnant women with a positive result for SARS-CoV-2 presenting with transaminitis in third trimester.

Results The clinical courses of four pregnant women with COVID-19 and transaminitis, three of four of whom were diagnosed with IHCP, are described. Testing for SARS-CoV-2 was done through a reverse transcription polymerase chain reaction test of a nasopharyngeal swab.

Conclusion As we await larger studies ascertaining the incidence of IHCP in SARS-CoV-2, this prevalence highlights the importance of diagnosing IHCP among women with COVID-19 as a potential etiology of transaminitis, as IHCP risks may be ameliorated with earlier delivery. Moreover, delineating a hepatobiliary association in pregnancy may provide further information about the mechanism of liver impairment in SARS-CoV-2 in all patients.

Keywords

COVID-19 - IHCP - intrahepatic cholestasis of pregnancy - maternal - novel coronavirus - SARS-CoV-2 - transaminitis


Publication History

Received: 15 August 2020

Accepted: 22 October 2023

Article published online:
23 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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