A study on feto-maternal outcome of intra hepatic cholestasis of pregnancy

Abstract

Background: Intrahepatic cholestasis of pregnancy is one kind of the hepatic disorder which is unique to pregnancy. It is associated with many adverse pregnancy outcomes if doesn’t intervened at right time. It requires adequate clinico-biochemical correlation during management.Methods: A prospective observational study was conducted at multispecialty government zonal hospital. Total 137 IHCP patients were managed during the study period from 01 Jan 2017 to 30 Jun 2019. Incidence and pregnancy outcome in form of several maternal and fetal factors were analysed by appropriate statistical test using spps software version 20.0.Results: During the study period total 4872 patients were undergoing delivery and 137 patients were diagnosed with IHCP. The incidence of IHCP was 2.81%. Majority of cases 75 out 137 (54.74%) were nulligravida. Total 29.92% (41/137) cases were underwent LSCS delivery and of this 21.17% (29/137) were primary caesarean delivery. There were three still birth noted in IHCP study population. Total 28 cases (20.44%) of IHCP were presented with preterm labour. And NICU admissions of the study population were 32 new born babies (23.36%). 2.18% case of still birth was noted among study population.Conclusions: IHCP causes significant maternal and neonatal morbidity and is major contributor of preterm delivery, caesarean delivery, meconium stained liquor and NICU admission.

Frequency of Fetomaternal Complications Due to Intrahepatic Cholestasis of Pregnancy

“…16 A study conducted in India by Binay et al reported that first symptoms of cholestasis appeared in 34-36 weeks of pregnancy in 66% cases and in 32-34 weeks in 15%, before 32 weeks I n 14% while at 37 weeks in 5% cases. 17 Another similar study by Eshadi et al reported vaginal delivery in 56.7% and cesarean section in 43.3% cases. 18 Aftab et al found perinatal outcomes in their study as 29% cases had meconium stained liquor, abnormal CTG detected in 17%, 18% had intrauterine retarded growth, 26% were premature births while 3% had intrauterine fetal death.…”

A Systematic Review On Complications of Intrahepatic Cholestasis of Pregnancy

“…However, there are not any sufficiently large randomised controlled trials to determine if ursodeoxycholic acid lowers the risk of unfavourable perinatal outcomes (Sitaula et al, 2021). Numerous studies support active treatment techniques that include prenatal monitoring that is intensified and intentional early deliveries (Mitra et al, 2020;Shafqat et al, 2022). Although there is little body of research to support these procedures, doctors must decide if the risks of an early birth exceed those of prolonging a pregnancy plagued by intrahepatic cholestasis (Parihar and Singh, 2019).…”