Maternal and fetal outcome in pregnancy complicated by intrahepatic cholestasis of pregnancy

Abstract

Objective

To assess the maternal and fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP).

Methods

This retrospective observational study was conducted between January 2020 and February 2023 in Naimat Begum Hamdard General Hospital, Karachi, Pakistan. All diagnosed cases of ICP with development of pruritus during the second or third trimester of pregnancy were included irrespective of age and gestational status. Maternal outcomes such as mode of delivery, postpartum hemorrhage, itching after delivery settled in a day or 2, and liver function test were also noted. While the fetal outcome such as preterm birth, low birth weight, meconium-stained amniotic fluid, APGAR score at 1 min, and APGAR score at 5 mins, admission in neonatal intensive care unit (NICU) after birth, stillbirth, and neonatal death were also noted.

Results

Of 76 patients, the median age of the patients was 27.5 (23.0-33.7) years. Forty-eight (63.2%) ICP women had cesarean section delivery, 14 (18.4%) had post-partum hemorrhage, and 40 (52.6%) had itching after delivery. Whereas 54 (71.1%) neonates were preterm, 43 (56.6%) were of low birth weight, 18 (23.7%) had meconium-stained amniotic fluid, 23 (30.3%) had APGAR score <7 at 1 min, 8 (10.5%) had APGAR score <7 at 5 mins, 6 (7.9%) had NICU admission, 4 (5.3%) had still birth, and neonatal death was observed in 5 (6.6%) neonates.

Conclusion

A high rate of cesarean section delivery, post-partum hemorrhage, preterm birth, low birth weight, and neonatal complications in women with ICP.