Abstract

Background:Cholestasis is defined as impairment of bile flow due to intrahepatic or extrahepatic
causes, leading to retention of hepatotoxic compounds; specifically bile acids. The present study was
conducted to evaluate the feto-maternal outcome in patients with intrahepatic cholestasis of
pregnancy.
Materials & Methods:It included 190 subjects in the study. Group A consisted of 95 women who
presented with pruritis in their second & third trimester of pregnancy with associated abnormal liver
function in the absence of other liver and skin disease. 95 women with uncomplicated pregnancy and
no history of pruritis& with normal liver function test were taken as Group B/control.
Results: out of 95 participants total induction were 45 (47.36%) in group A and 13 (13.68%) in group
B. Out of 45 (47.36%) total induction, 30 (31.57%) had vaginal delivery and 15 (15.78%) had LSCS
in group A. Similarly, out of 13 (13.68%) total induction, 11 (11.57%) had vaginal delivery and 2
(2.10%) had LSCS in group B. ICP was significantly associated with induction of labour. There is
higher incidence of caesarean section in induced patients. There is significant correlation in group A
and group B in terms of fetal complications (p<0.001). 1 (1.05%) participants of APGAR score <7 at
5 minutes of age in group A and group B each. The risk of adverse fetal outcomes increases with
increasing levels of maternal serum bile acid. 24 (25.26 %) babies of group A and 7 (7.36 %) babies
of group B were admitted in NICU.
Conclusion: Higher rates of gestational diabetes and pre-eclampsia are new findings, and need to be
considered in management of ICP pregnancies. Caesarean section as mode of delivery found
significantly associated with ICP. Maternal outcomes have good prognosis but foetal outcomes can be
improved by timely and effective interventions.