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Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis

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Abstract

Objective

To study the incidence, maternal, and perinatal outcomes in intrahepatic cholestasis of pregnancy with active management.

Materials and Methods

This observational study included 48 cases diagnosed as intrahepatic cholestasis of pregnancy. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37–38 weeks) were offered to all. Maternal and perinatal outcomes are studied.

Results

Incidence of ICP was 2.4 %. More than 86 % of patients presented with generalized pruritus mostly after 30 weeks. Incidences of Intrapartum abnormal cardiotocography (12.5 %) and thick meconium (8.33 %) were high. Cesarean section rate was high (41.66 %). Most common indications were CDMR, fetal distress, and non-progress of labor. Incidence of preterm labor, IUGR, Apgar score (<7), and neonatal admission rate were not high. There was one stillbirth at 36 weeks of gestation. Serum transaminase levels tended to be higher in patients with poor perinatal outcomes, such as stillbirth, fetal distress, and meconium-stained amniotic fluid.

Conclusion

Serum transaminase levels tended to be higher in patients with poor perinatal outcome. Perinatal outcome is good with active management, at the cost of higher LSCS rate. Further randomized controlled trial of early versus spontaneous delivery may be justified.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya, 793018, India

    Nalini Sharma, S. Panda & Ahanthem Santa Singh

Authors
  1. Nalini Sharma
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  2. S. Panda
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  3. Ahanthem Santa Singh
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Corresponding author

Correspondence to Nalini Sharma.

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Conflict of Interest

Nalini Sharma, Subrat Panda, and Ahanthem Santa Singh declared that they have no conflict of interest.

Ethical Approval

Institutional ethical Committee clearance was obtained for study.

Informed Consent

Informed consent was obtained from all patients for being included in study.

Additional information

Nalini Sharma is an Assistant Professor; S. Panda is an Associate Professor and Ahanthem Santa Singh is a Professor and Head at the Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya.

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Sharma, N., Panda, S. & Singh, A.S. Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis. J Obstet Gynecol India 66 (Suppl 1), 38–41 (2016). https://doi.org/10.1007/s13224-015-0768-8

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  • DOI: https://doi.org/10.1007/s13224-015-0768-8

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