Touching Lives - February 2008
Stillbirth and obstetric cholestasis - the heart of the problem
We do not understand why some of these babies die. It’s also unclear whether a drug called ursodeoxycholic acid (UDCA), which relieves the mother’s itch, could also benefit babies. It has long been known that pregnant women with obstetric cholestasis have abnormally high levels of bile acids in their blood because the liver is not working properly. Researchers from Imperial College London, led by Dr Julia Gorelik, suspect these raised levels of bile acids might endanger unborn babies by causing their heart to beat abnormally, putting them at risk of a heart attack. To test their theory, the researchers, using funding from Action Medical Research, are performing a series of sophisticated laboratory studies of fetal and adult heart cells. They are measuring changes in heart rhythms when cells are exposed to bile acids and investigating the mechanisms by which this happens.The team is also examining whether UDCA can protect the heart cells from the effects of bile acids, again looking for a detailed explanation of how this happens. The ultimate aim is to find a successful new treatment for obstetric cholestasis, freeing expectant mothers from worries that the condition may harm their babies, and helping avoid the heartbreak of stillbirth.