Maternal and Perinatal Outcome in Cholestasis of Pregnancy

Abstract

Background: Intrahepatic cholestasis of pregnancy has been associated with adverse perinatal outcomes but mechanisms are poorly understood and optimal management is uncertain. Intrahepatic cholestasis of pregnancy or obstetric cholestasis is the most common pregnancy related  liver disorder. Hence; the present study was planned for assessing the maternal and perinatal outcome in cholestasis of pregnancy. Subjects and Methods: A total of 50 subjects were enrolled in the present study. Out of these 50 subjects, 25 were of pregnant women with confirmed diagnosis of Intrahepatic cholestasis of pregnancy (IHCP), while the remaining 25 were healthy pregnant women (taken as control). Diagnosis of IHCP was done on the basis of presence of unexplained pruritus in addition to increased bile acids and/or transaminases during the late second and third trimester of pregnancy. Complete demographic details of all the patients were obtained. Clinical examination of all the patients was done and haematological profile was obtained. Regular follow-up and check-up of all patients was done throughout the pregnancy extending upto a time period to 3 weeks postpartum. Complications, if any, were recorded separately. Results: Mean serum bilirubin, SGOT and SGPT levels of the subjects of the IHCP group were found to be significantly higher in comparison to the subjects of the control group. Pre-term deliveries were found to be present in 5 subjects of the IHCP group, while they were present in 2 subjects of the control group. While comparing the intra-partum complications in between the two study groups, non-significant results were obtained. NICU stay was found to be present in 4 neonates of the IHCP group while it was present in 1 neonate of the control group. Mean birth weight was found to be 3.45 Kg in the IHCP group while it was found to be 3.19 Kg in the control group. Morbidity was absent in both the study groups. Conclusion: Pregnant women with IHCP are at a higher risk for having pre-term delivery. Although, no significant difference was observed in terms of complications, still these subjects are slightly higher risk of adverse events.