Abstract

A Study of Obstetric Intrahepatic Cholestasis and Its Maternal and Perinatal Outcome at a Tertiary Care Hospital in Nagpur

Author(s): Payal Jaywant Vaidya1, Sumit Ashok Kumbhalwar2, Makarand Jaywant Vaidya3

BACKGROUND
Intrahepatic cholestasis of pregnancy (ICP) is a multifactorial pregnancy specific
liver disorder which is also known as obstetric cholestasis. The purpose of this
study was to establish the value of maternal serum bile acid in diagnosis of ICP,
evaluate the treatment of ICP with UDCA (ursodeoxycholic acid) and its influence
on maternal and neonatal outcome.
METHODS
It was a cross-sectional study. 90 women diagnosed with ICP were studied for a
period of 2 years and 3 months at tertiary care government hospital. Statistical
analysis was performed using chi square test. ‘P’ value of < 0.05 was considered
as statistically significant in this observational study.
RESULTS
The present study evaluates that ICP is more common in multigravida and in age
group of 26 years – 30 years. It recurs in subsequent pregnancies significantly.
Itching, most common symptom is commenced at 34 weeks ± 2.85 weeks.
Transaminases were normal with elevated serum bile acid levels in 32.33 % cases.
The mean gestational age at delivery ranged between 35 to 39 weeks. Most
common mode of delivery is lower segment caesarean section (LSCS) with
commonest indication as meconium-stained amniotic fluid (MSAF) and 31 babies
required neonatal intensive care unit (NICU).
CONCLUSIONS
Precise diagnosis, follow up, target medication and active management is required.
Although maternal outcome for patients is good and without any long-term
sequelae, fetal outcome can be devastating. Active management with close
antenatal surveillance of the fetus is usually recommended for better perinatal
outcome.