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What Do My Lab Test Reports Indicate?
Question: Hi.
I am in my 38th week of pregnancy. I have a query about SGOT (AST) & SGPT (ALT).
In my 8th month I started having itchining. Initialy I ignored it but later I read and suspected ICP. So I got the LFT test done.
Itching started July begning.
LFT Test results on 24-July (36th Week)
- SGOT - 107 U/L
- SGPT - 108 U/L
- ALP - 171 U/L
Doctor suggested UDILIV 300 MG twice a day.
We also got "Total Bile Acid Test" done and result was 6.0 umol/l.
LFT Test repeated on 03-Aug (37th Week)
- SGOT - 51 U/L
- SGPT - 40 U/L
- ALP - 152 U/L
It seems that the UDILIV was working and SGOT and SGPT were reduced.
LFT Test repeated on 09-Aug (38th Week)
- SGOT - 59 U/L
- SGPT - 47 U/L
- ALP - 168 U/L
Howeve in the latest test, SGOT and SGPT are little higher than last time.
Questions:
1. Should we go for Caesarian delivery immediately given the values of SGOT and SGPT? Our preference is normal (vaginal) delivery.
2. Even though the results of "Total Bile Acid Test" were normal, can a high SGOT and SGPT signify ICP? Itching is in control but it is still there.
= Details =
------------
Age: 32 years
First pregnancy.
LMP - 22-Nov-2014
EDD - 29-Aug-2015
38th week in progress. No signs of labor yet.
= Medical History =
-------------------
1. Gestational Diabetes: Detected in 31st week. It is in control with Diet and no medicine/insulin is used. I monitor regularly using home test kit.
2. Thyroid: Pre-pregnancy TSH was 5.23. TSH was 3.2 when pregnancy was detected (one month after the LMP) and since then it is in control using daily medicne (Thyronorm 25mg). Monitored regularly.
3. Blood pressure has been normal throughout. Pulse rate has been high since 5th month (mostly 100-110). Additionally, during the 5th & 6th months palpatations were felt regularly.
I am in my 38th week of pregnancy. I have a query about SGOT (AST) & SGPT (ALT).
In my 8th month I started having itchining. Initialy I ignored it but later I read and suspected ICP. So I got the LFT test done.
Itching started July begning.
LFT Test results on 24-July (36th Week)
- SGOT - 107 U/L
- SGPT - 108 U/L
- ALP - 171 U/L
Doctor suggested UDILIV 300 MG twice a day.
We also got "Total Bile Acid Test" done and result was 6.0 umol/l.
LFT Test repeated on 03-Aug (37th Week)
- SGOT - 51 U/L
- SGPT - 40 U/L
- ALP - 152 U/L
It seems that the UDILIV was working and SGOT and SGPT were reduced.
LFT Test repeated on 09-Aug (38th Week)
- SGOT - 59 U/L
- SGPT - 47 U/L
- ALP - 168 U/L
Howeve in the latest test, SGOT and SGPT are little higher than last time.
Questions:
1. Should we go for Caesarian delivery immediately given the values of SGOT and SGPT? Our preference is normal (vaginal) delivery.
2. Even though the results of "Total Bile Acid Test" were normal, can a high SGOT and SGPT signify ICP? Itching is in control but it is still there.
= Details =
------------
Age: 32 years
First pregnancy.
LMP - 22-Nov-2014
EDD - 29-Aug-2015
38th week in progress. No signs of labor yet.
= Medical History =
-------------------
1. Gestational Diabetes: Detected in 31st week. It is in control with Diet and no medicine/insulin is used. I monitor regularly using home test kit.
2. Thyroid: Pre-pregnancy TSH was 5.23. TSH was 3.2 when pregnancy was detected (one month after the LMP) and since then it is in control using daily medicne (Thyronorm 25mg). Monitored regularly.
3. Blood pressure has been normal throughout. Pulse rate has been high since 5th month (mostly 100-110). Additionally, during the 5th & 6th months palpatations were felt regularly.
Brief Answer:
No need of immediate delivery
Detailed Answer:
Hello mam, thanks for trusting health care magic.
Its good to have a detailed description of all the problems with proper dates and values.
There is no need to go for immediate delivery as the values are normal.
In pregnancy normal values of SGOT/PT are below 60 and thus if they fluctuate 5-10 units from previous values then nothing to worry at all.
There is nothing against normal delivery and you can very well opt for normal delivery but under strict fetal heart rate monitoring as in patients with ICP there is high risk of meconium passage and thus distress in baby so a strict monitoring is always needed but usually normal delivery occurs without any adverse effects on baby or mother.
You are in your 37 running week and thus there will not be labor pain so early and thus you still need to wait for another week and then opt for induction of labor and normal delivery.
Symptoms of itching with raised SGOT/PT levels are quite indicative of ICP even if total bile is normal.
Keep taking your thyroid medicine and monitor your blood glucose levels.
Visit hospital immediately in case you get labor pains or there is excessive watery discharge from vagina or in case you feel lesser fetal movements than before.
Take care
Regards
Dr Manisha
No need of immediate delivery
Detailed Answer:
Hello mam, thanks for trusting health care magic.
Its good to have a detailed description of all the problems with proper dates and values.
There is no need to go for immediate delivery as the values are normal.
In pregnancy normal values of SGOT/PT are below 60 and thus if they fluctuate 5-10 units from previous values then nothing to worry at all.
There is nothing against normal delivery and you can very well opt for normal delivery but under strict fetal heart rate monitoring as in patients with ICP there is high risk of meconium passage and thus distress in baby so a strict monitoring is always needed but usually normal delivery occurs without any adverse effects on baby or mother.
You are in your 37 running week and thus there will not be labor pain so early and thus you still need to wait for another week and then opt for induction of labor and normal delivery.
Symptoms of itching with raised SGOT/PT levels are quite indicative of ICP even if total bile is normal.
Keep taking your thyroid medicine and monitor your blood glucose levels.
Visit hospital immediately in case you get labor pains or there is excessive watery discharge from vagina or in case you feel lesser fetal movements than before.
Take care
Regards
Dr Manisha
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks Dr. XXXXXXX Your answer is very crisp and reassuring. This is exactly what I expected from Second Opinion Follow up queston: Do I need to change the medication or dosage for SGOT/SGPT. As of now, I take UDILIV 300MG twice every day. .
Brief Answer:
No need to increase the dose
Detailed Answer:
Thanks a lot for the compliment.
No need to increase the dose as her enzyme levels are well within normal limits.
Most important thing that she needs to do is to keep a note of the fetal movements and visit the doctor at the earliest in case she feels lesser than normal movements.
All the best.
No need to increase the dose
Detailed Answer:
Thanks a lot for the compliment.
No need to increase the dose as her enzyme levels are well within normal limits.
Most important thing that she needs to do is to keep a note of the fetal movements and visit the doctor at the earliest in case she feels lesser than normal movements.
All the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor.
You mentioned in your answer:
"You are in your 37 running week and thus there will not be labor pain so early and thus you still need to wait for another week and then opt for induction of labor and normal delivery."
I guess you thought I am in 37th week. However, I completed 37th week 2 days ago and I am now in 38th week (precisely 37w 2d).
We monitor the Fetal movements regularly.
Last week (4th-Aug, i.e. middle of 37th week), we suspected less fetal movements and we immediately went to the Hospitals's labor room for NST. At first the results were not good. They asked me to take a meal and come back. After the meal the NST results were normal.
We got an Ultrasound done next day. We told the radiologist about the reduction in fetal movements and NST the previous day. During the test he mentioned that although baby is moving, it is moving smaller parts of the body, not the whole body. Ultrasound Report is attached - Biophysical profile score is 7/8.
Our regular Doctor suggested to continue the Fetal movements monitoring.
Since then, the Fetal movements are regular and fine.
So the questions are:
1. Do you suggest that we should not wait for labor to start natually (whether it happens now or in 40th week)?
2. If yes, is it because of SGOT/SGPT levels or any other reason?
3. If yes, do you suggest that we go for delivery at the end of 37th, 38th or 39th week?
You mentioned in your answer:
"You are in your 37 running week and thus there will not be labor pain so early and thus you still need to wait for another week and then opt for induction of labor and normal delivery."
I guess you thought I am in 37th week. However, I completed 37th week 2 days ago and I am now in 38th week (precisely 37w 2d).
We monitor the Fetal movements regularly.
Last week (4th-Aug, i.e. middle of 37th week), we suspected less fetal movements and we immediately went to the Hospitals's labor room for NST. At first the results were not good. They asked me to take a meal and come back. After the meal the NST results were normal.
We got an Ultrasound done next day. We told the radiologist about the reduction in fetal movements and NST the previous day. During the test he mentioned that although baby is moving, it is moving smaller parts of the body, not the whole body. Ultrasound Report is attached - Biophysical profile score is 7/8.
Our regular Doctor suggested to continue the Fetal movements monitoring.
Since then, the Fetal movements are regular and fine.
So the questions are:
1. Do you suggest that we should not wait for labor to start natually (whether it happens now or in 40th week)?
2. If yes, is it because of SGOT/SGPT levels or any other reason?
3. If yes, do you suggest that we go for delivery at the end of 37th, 38th or 39th week?
Brief Answer:
Continue till 39 weeks
Detailed Answer:
If fetal movements stay normal then you can continue till 39 completed weeks and then get induction of labor but in case she gets labour pains before that then visit the doctor immediately as the baby is mature so can be delivered anytime now.
Im advising this because of the previously raised enzyme levels so it is not advisable to wait beyond 39 completed weeks.
In my opinion now since enzyme levels are normal everything will be fine but still we need to stay cautious.
Wish you a healthy baby soon.
Continue till 39 weeks
Detailed Answer:
If fetal movements stay normal then you can continue till 39 completed weeks and then get induction of labor but in case she gets labour pains before that then visit the doctor immediately as the baby is mature so can be delivered anytime now.
Im advising this because of the previously raised enzyme levels so it is not advisable to wait beyond 39 completed weeks.
In my opinion now since enzyme levels are normal everything will be fine but still we need to stay cautious.
Wish you a healthy baby soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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