Obstetric cholestasis and its impact on the maternal outcome

Abstract

AIM To evaluate the association of GDM and pre-eclampsia in women with obstetric cholestasis MATERIAL AND METHODS Pregnant women with >28weeks gestation attending ANC, OPD and labour room of J.N.M.C.H,AMU, Aligarh U.P (India) from 2020-2022 were included in the study after taking informed consent and ethical approval from the Institute. Women were divided into two groups ie group 1 having 200 women with IHCP and group 2 having 200 healthy pregnant women, both the groups were followed up for the development of GDM and pre-eclampsia. RESULTS A statistically significant association was observed between IHCP and development of GDM (26.5% & Odds ratio 1.64) and pre-eclampsia (17% & Odds ratio 1.95) (p<0.05), also GDM and pre-eclampsia were found to be significantly associated with the severity of cholestasis (p<0.05). Thus on calculating odds ratio, we found higher odds of developing GDM and Pre-eclampsia in IHCP group with raised serum bile acid levels, maximum at 60μmol/L level as compared to 10-40 μmol/L (GDM: OR:8.647 & Pre-eclampsia: OR:6.303). Induction and cesarean rate was significantly higher in IHCP group (p<0.05). CONCLUSION Our study concludes significant association of IHCP with GDM and Pre- eclampsia as all three shares common pathogenetic pathways and greater risk of development was at higher serum bile acid levels.