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Obstetrical and fetal outcomes of a new management strategy in patients with intra-hepatic cholestasis of pregnancy

  • Materno-fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purposes

To determine the incidence, obstetrical, and fetal complication rates of intrahepatic cholestasis of pregnancy (ICP) in patients managed expectantly to 40-weeks gestation.

Methods

In a prospective cohort study conducted between February 2008 and January 2010, a total of 21,960 pregnant women in Qassim Region of Saudi Arabia were screened for ICP using specific criteria for diagnosis. The course of pregnancy was monitored to 40-weeks gestation or spontaneous onset of labor, whichever comes first. The measured outcomes were compared with a cross-matched group of healthy pregnant women. Continuous variables were analyzed with t test, while χ2 test was used for comparing percentages.

Results

The incidence of ICP was 0.35% (76/21,960). There was no significant difference between groups in gestational age at delivery, preterm labor, intrauterine fetal death, cesarean section, or respiratory distress syndrome. There was significantly higher intrapartum non-reassuring fetal heart rate patterns and meconium-stained amniotic fluid in ICP group (P < 0.01 and <0.0001, respectively).

Conclusions

The incidence of ICP in this region is low compared to worldwide range. Expectant management to 40-weeks gestation is associated with obstetrical and fetal outcomes comparable to normal pregnancy; however, intrapartum fetal asphyxia is more likely.

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Conflict of interest statement

The authors have no a financial relationship with organizations that sponsored the research or any conflict of interest to be declared.

Author information

Authors and Affiliations

  1. Department of Dermatology, Qassim University, Qassim, Saudi Arabia

    Hani A. Al Shobaili, Ahmad Al Robaee & Abdullateef A. Alzolibani

  2. Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Qassim, Saudi Arabia

    Hossam O. Hamed & Ahmad F. Amin

  3. College of Medicine, Assiut University, Assiut, Egypt

    Hossam O. Hamed

  4. P.O. Box 30109, Buraidah, Qassim, 51477, Saudi Arabia

    Hossam O. Hamed

  5. Department of Obstetrics and Gynecology, Maternity-Childhood Hospital, Qassim, Qassim Region, Saudi Arabia

    Salah R. Ahmad

Authors
  1. Hani A. Al Shobaili
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  2. Hossam O. Hamed
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  3. Ahmad Al Robaee
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  4. Abdullateef A. Alzolibani
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  6. Salah R. Ahmad
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Correspondence to Hossam O. Hamed.

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Al Shobaili, H.A., Hamed, H.O., Al Robaee, A. et al. Obstetrical and fetal outcomes of a new management strategy in patients with intra-hepatic cholestasis of pregnancy. Arch Gynecol Obstet 283, 1219–1225 (2011). https://doi.org/10.1007/s00404-010-1506-1

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  • DOI: https://doi.org/10.1007/s00404-010-1506-1

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