Perinatal follow up and neonatal outcomes of pregnancies with obstetric cholestasis

Abstract

Introduction. Obstetric cholestasis is the most common liver disease during pregnancy, which is predominantly associated with fetal complications. Material and Methods. This retrospective study included a total of 44 pregnant women with obstetric cholestasis who gave birth at the Clinic of Obstetrics and Gynecology, Clinical Center of Vojvodina, Novi Sad, from January 1, 2014 to December 31, 2018. Results. The average maternal age was 34 years. The mean gestational age at diagnosis of obstetric cholestasis was 31 weeks, and at the time of delivery 35 weeks of gestation. Abdominal pruritus was the main symptom of the disease affecting 72.72% of patients. The mean bile acid level in the blood at the time of diagnosis was 25.26 ?mol/L. Twenty nine patients (65.90%) gave birth vaginally, while 15 (34.09%) underwent cesarean section. The main maternal complication was postpartum hemorrhage. The average blood loss was 567 ml. There were no maternal deaths or stillbirths. The average newborn birth weight was 2830 g. Respiratory distress syndrome was diagnosed in 8 newborns (15.09%). The mean Apgar score at 1minute was 7, while at 5 minutes it was 9. Conclusion. Individual approach, continuous clinical and laboratory monitoring with adequate therapeutic treatment are necessary in patients with obstetric cholestasis.