Maternal and Fetal Outcome in Patients with Obstetric Cholestasis
Objective: To determine maternal and fetal outcome in patients with obstetric cholestasis
Methdology: The descriptive case series study was conducted in obstetrics and gynaecology department of federal govt polyclinic hospital after approval from the ethical committee. The duration of study was from 1 may 2016 to 30 April 2017. In this study, total 100 patients were included. During study period,al patients presenting with pruritis and or deranged liver function tests were included.Patients with gestational amenorrhea more than 20 weeks with raised ALT and AST along with normal ultrasound abdomen and no preexisting liver disease were said to have obstetric cholestasis. Maternal and fetal outcome was observed. Maternal outcome include mode of delivery. Fetal outcome include prematurity,meconium staining of liquor and fetal distress.
Results: Out of 100 patients,38 had spontaneous vaginal deliveries with percentage of 38%.Lower segment caesarean section rate was 62%. 7% of patients had premature delivery.There were 2 intrauterine deaths and Neonatal Intensive Care Unit admission rate was 49%. 45% of patients had meconium staining of liquor.11% of patients went in to postpartum haemorrhage.There were 45 primigravidas and 55 multigravidas.
Conclusion: Caesarean section rate was high in this study.Some caesarean sections were due to failed induction of labor but majority were due to fetal distress.Whether this high rate was due to active management of obstetric cholestasis or due to disease process remains to be ascertained.Premature delivery rate was lower in this study and fetal outcome was also good on overall basis despite 49% NICU admission rate.Take home baby rate was high.All babies were well at one month follow up visit.
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