Contractile Effects of Cholic Acid and Bilirubin on Umbilical Arterial Circle in vitro.

doi:10.3877/cma.j.issn.1673-5250.2009.02.110

Objective

To investigate contractile effects of various concentration of cholic acid and bilirubin/cholic acid in vitro on umbilical arterial circle, and study the mechanism of fetal distress and fetal death in uterus of gravida with intrahepatic cholestasis of pregnancy.

Methods

From September 2003 to October 2003, 24 cases who were admitted to the department of Obstetrics of the Union Hospital affiliated to TongJi University to delivery. All of them were healthy and without pregnant complications. The umbicial cords were taken as the investigative objects. The procedure of the study following is according to ethical criterion which made by the somatological test committee of the Union Hospital affiliated to TongJi University receiving the sanction of the committee and the agreement of the patients. Informed consent was obtained from all paticipates. The contractile values of umbilical arterial circle by the stimulation of cholic acid and bilirubin/cholic acid (cholic acid group, n=24; bilirubin/cholic acid group, n=24) were recorded. The correlation between umbilical arterial circle's contraction and concentration of cholic acid and bilirubin/cholic acid were analyzed.

Results

With the certain concentration, the contractile values of cholic acid on umbilical arterial circle were (22.13±12.05) mg, (42.04±18.35) mg, (73.88±32.92) mg, (112.63±48.90) mg, (154.54±52.07) mg, while the contractile values of bilirubin/cholic acid on umbilical arterial circle were (35.29±13.31) mg, (68.63±25.13) mg, (116.00±42.8) mg, (168.29±49.11) mg, respectively.

Conclusion

Various concentration of cholic acid can stimulate the umbilical arterial circle to shrink with a pattern of dose-dependent. Bilirubin/cholic acid have synergistic action to it. The contractile effect of umbilical arterial circle by high concentration of cholic acid and bilirubin may be an important cause of fetal distress and fetal death in uterus of gravida with intrahepatic cholestasis of pregnancy.

Key words: intrahepatic cholestasis of pregnancy (ICP), cholic acid, bilirubin, umbilical artery, arterial circle

图1　胆酸、胆红素／胆酸对脐动脉血管环的收缩作用

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