The Relationship Between Intrahepatic Cholestasis Of Pregnancy And Vascular Endothelial Growth Factor

Intrahepatic cholestasis of pregnancy.(ICP) occur at middle later or term pregnancy with skin pruritus, jaundice and high bile acids level of women, the fetal prognosis is worse than maternal.It can lead to fetal distress,fetal death in uteri or premature birth, all that increase perinatal incidence and mortality of fetal. lots of doctors research its pathogenesis and the reason why it is so harm to fetus ,Most of them find that occurrence of fetal perinatal incidence and mortality relate with high concentration bile acids in pregnant women blood. Vascular endothelial growth factor (VEGF) secreted by vascular endothelial cells is most important angiogenin to stimulate angiogenesis and keep vascular wall permeability, And accelerate vascular generation and vascular development. During the third trimester of pregnancy, vascular generation and vascular development is depressed, the most important action of VEGF is increasing vascular permeability.34 ICP patients including mild (n=18) and severe (n=16) and 30 normal later pregnancy women(NLP) were observed in this study. Radio-immunity method is used to assay the content of glycocholic acid in blood .VEGF in placenta is examined by western blot. Serum VEGF concentrations in mother blood were determined by sandwich enzymelinked immunoadsorbent assay (ELISA). density in placenta and decidua are detected by s-ABC immunohistochemistry.The relationship among bile acids, VEGF ,vascular density in ICP patients were investigated in order to comprehend the relativity VEGF with fetaldistress and fetal death.the main results and conclusions are as follows:1. Plasma CG level of patients with ICP significantly is increased and is closely related to the severity of ICP.2. CG level of cord blood with ICP is markedly higher than that of mother blood with a positive correlation between them.3. CG concentration in mother blood with ICP is negative correlation with VEGF, however, it isn't correlation in NLP.4. The distribution of VEGF in placenta is similar in ICP and NLP ,but quantum expression of VEGF is significantly lower in ICP than that of VEGF in NLP, there is positive correlation between quantum expression of VEGF and vascular density of NLP .5. CG concentration in mother blood with ICP is negative correlation with vascular density of ICP in placenta and deciduas. Cytotoxicity of high concentration bile acids impairs vascular endothelial cells resulting in lower excretion of VEGF in vascular endothelial cells in ICP, which lead to placental blood capillaries dysplasia and lower permeability. It can be one of reasons of fetal distress and fetal death in uteri. So therapy of ICP patients is to decrease the concentration of bile acids and reinforce blood circulation of placenta.