Foetal Outcome in Intrahepatic Cholestasis of Pregnancy Treated with Ursodeoxycholic Acid

Abstract

Objective: To determine frequency of foetal outcome in patients with intrahepatic cholestasis of pregnancy treated with Ursodeoxycholic Acid (UDCA).

Methodology: The study was conducted at the Department of Gynaecology and Obstetrics, Jinnah Postgraduate Medical Center, Karachi, from 14-03-2017 to 13-03-2020. This interventional single-group cohort study included 139 pregnant women with ICP who received UDCA at a dose of 15 mg/kg orally for up to 6 weeks or until delivery/C-section. Weekly LFTs, urine analysis, and foetal ultrasounds were conducted. Weekly liver function tests (LFTs), urine analysis, and foetal ultrasounds were performed, and foetal outcomes were recorded. Descriptive statistics were used to analyze both qualitative and quantitative variables.

Results: The mean age of the participants was 27.3 ± 3.8 years, with a mean parity of 2.2 ± 1.4. The average family income was PKR 20,611.51 ± 7,057.23. Among the participants, 78 (56.1%) had a primary level of education, while 61 (43.9%) had a secondary level of education. The mean duration of UDCA treatment was 4.7 ± 1.8 weeks. The study revealed that 4 (2.9%) foetuses experienced intrauterine death (IUD), and 45 (32.4%) foetuses suffered from neonatal distress. However, 90 (64.7%) healthy babies were born. Additionally, 22 (15.8%) cases had meconium-stained amniotic fluid (MSAF), and 21 (15.1%) pregnancies resulted in preterm births. Significant correlations were found between parity and maternal age, MSAF and foetal outcome, anaemia and foetal outcome, and preterm delivery with maternal age. Gestational age was significantly correlated with all variables except parity.

Conclusion: The findings of this study support the use of UDCA in pregnant women with ICP, as it demonstrated beneficial effects on foetal outcomes.