A study of obstetric cholestasis

Padmaja, Mekala; Pal, Bhaskar; Kumar, Gupta Jayanta; Ramamurthy, Seetha; Mahasweta, Chaudhuri

doi:10.1007/s13224-010-0030-3

Cited by 24 publications

(41 citation statements)

References 7 publications

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“…It has been reported that itching may be present either before or after abnormal liver function test is detected and this may reflect the heterogeneous nature of the condition [10]. Serum bilirubin was elevated in 40 % of cases comparable to other studies [12], but there was only one case of clinical jaundice. ICP has been associated with increased risk of preterm delivery (up to 19-60 %), meconium staining of amniotic fluid (up to 27 % cases), fetal bradycardia (up to 14 %), fetal distress (22-41 %), and fetal loss (0.4-4.1 %) [5,6] particularly when serum bile acid level goes beyond 40 mmol/l [11,13].…”

Section: Discussionsupporting

confidence: 74%

Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis

Sharma

Panda

Singh

2015

J Obstet Gynecol India

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Objective To study the incidence, maternal, and perinatal outcomes in intrahepatic cholestasis of pregnancy with active management. Materials and Methods This observational study included 48 cases diagnosed as intrahepatic cholestasis of pregnancy. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcomes are studied. Results Incidence of ICP was 2.4 %. More than 86 % of patients presented with generalized pruritus mostly after 30 weeks. Incidences of Intrapartum abnormal cardiotocography (12.5 %) and thick meconium (8.33 %) were high. Cesarean section rate was high (41.66 %). Most common indications were CDMR, fetal distress, and non-progress of labor. Incidence of preterm labor, IUGR, Apgar score (\7), and neonatal admission rate were not high. There was one stillbirth at 36 weeks of gestation. Serum transaminase levels tended to be higher in patients with poor perinatal outcomes, such as stillbirth, fetal distress, and meconium-stained amniotic fluid. Conclusion Serum transaminase levels tended to be higher in patients with poor perinatal outcome. Perinatal outcome is good with active management, at the cost of higher LSCS rate. Further randomized controlled trial of early versus spontaneous delivery may be justified.

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Section: Discussionsupporting

confidence: 74%

Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis

Sharma

Panda

Singh

2015

J Obstet Gynecol India

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“…Percentage of preterm birth in present study was found to be 25% with 16 cases delivered at 36-37 weeks, 8 cases at 35-36 weeks and 6 cases at <35 weeks. The findings correlates well with studies like Padmaja et al 11 16 (32%) found higher LBWs rate which may be due to elective early induction in study by Medda et al 16 . LBW was mostly due to preterm delivery, and association with other maternal factor like PIH and twin pregnancy may be the reason.…”

Section: Discussionsupporting

confidence: 90%

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Nisha¹,

Singh²,

Kumari³

2019

jemds

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BACKGROUND Pruritus is the primary clinical symptom of ICP. It may considerably impair the patient's quality of life causing sleep deprivation, psychological suffering and even suicidal thoughts. Pruritus is most severe in the evening, with a predilection for the palms of the hands and soles of the feet, and is not associated with any specific skin lesions. The main biochemical alterations are elevations of serum bile acids and aminotransferase activities. We wanted to study the outcome of pregnancy complicated by obstetric cholestasis in terms of maternal and foetal outcome. METHODS This is a prospective study done over a period of 18 months in 80 booked antenatal patients who complained of pruritus during their pregnancy. They were followed, and maternal and perinatal outcomes recorded. Appropriate statistical analysis was used for result. RESULTS Incidence of obstetric cholestasis in our hospital was 5%. Majority of the patients were primigravida (60%) and presented at gestational age between 32-36 weeks. Maternal morbidities are due to sleep disturbance (68.75%), dyslipidaemia (48.75%), deranged coagulation profile (22.5%), PPH (8.75%), increased operative interference (57.5%) and PROM (23.75%). Perinatal outcomes were MSL (23.75%), prematurity (25%), stillbirth (2.5%), NICU admission (18.75%), foetal distress (20%) and LBW (18.75%). Maximum number of patients were delivered between 37-38 weeks. CONCLUSIONS Active and timely intervention is needed to avoid unnecessary and early intervention and prevent the risk of prematurity.

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“…According to 9 Padmaja et al, Intrapartum fetal distress seen in 4.4% women with obstetrics cholestasis which is low attributed to proper ANC visits and timely treatment of obstetrics cholestasis. Rioseco et al, incidence of intrapartum.…”

Section: Resultsmentioning

confidence: 99%

Maternal and Foetal outcome in Cholestasis of Pregnancy

Sinha

Pandey

Das

2017

J. Nepalgunj Med. College

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Background: Obstetric cholestasis has been associated with an increased risk of preterm delivery, intrapartum meconium, foetal distress and intrauterine foetal death. Objectives: To know the perinatal outcome of cholestasis in pregnancy. Materials & Methods: This is a hospital based Observational study conducted in the department of Obstetrics & Gynaecology at Nepalgunj Medical College Teaching Hospital Kohalpur between August 2015 to January 2016.A total of 40 patients were included in the study with diagnosis of obstetric cholestasis. Data were recorded & analysed. Results: The study group of 40 mothers delivered 40 new born. Mean age group of women in the study was 24.9±5.5 years & 70% were primigravida. The mean gestational age at onset of pruritus was 30.33±4.24 weeks. The rate of caesarean section was 40%. Premature membrane rupture noted in 20% cases while 17.5% were postpartum haemorrhage. Regarding foetal outcome; meconium baby 32.5%, Intrapartum foetal distress 17.5%, preterm baby 10% while 37.5% were complication free. There was 2.5% of intrauterine foetal death, where pregnancy continued beyond 38 weeks. Thirteen new borns (32.5%) were admitted to neonatal intensive care unit. Conclusion: Cholestasis in pregnancy is high risk group with adverse perinatal outcomes.

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A study of obstetric cholestasis

Cited by 24 publications

References 7 publications

Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis

Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Maternal and Foetal outcome in Cholestasis of Pregnancy

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