January 2020 · Volume 9 · Issue 1 Page 318
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Mitra B et al. Int J Reprod Contracept Obstet Gynecol. 2020 Jan;9(1):318-322
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
A study on feto-maternal outcome of intra hepatic
cholestasis of pregnancy
Binay Mitra, Debkalyan Maji*, D. S. Borse
INTRODUCTION
Pregnancy brings several reversible and irreversible
changes to maternal physiology during its course. Almost
all maternal systems undergo some kind of adaptation to
pregnancy. Hepatobiliary system also undergoes several
changes which can be appreciated clinically and
biochemically. Intra Hepatic cholestasis of pregnancy
(IHCP) is one such liver disorder which is unique to
pregnancy.
IHCP is found among all ethnic groups with marked
variation in incidence. It affects 0.2-2% of pregnant
women worldwide.
1
IHCP cases are almost double in
Asian women compared to European women. The highest
incidence of IHCP (~4%) was found in indigenous
women from Chile and Bolivia.
2
The maternal complication associated with IHCP are
increased risks of post-partum haemorrhage, operative
delivery, severe pruritus with dyslipidemia and deranged
coagulation profile, preterm prelabour rupture of
membrane.
3
IHCP is associated with increased risk of
adverse perinatal outcomes like spontaneous preterm
birth, meconium staining of the amniotic fluid and
stillbirth.
4
ABSTRACT
Background: Intrahepatic cholestasis of pregnancy is one kind of the hepatic disorder which is unique to pregnancy.
It is associated with many adverse pregnancy outcomes if doesn’t intervened at right time. It requires adequate
clinico-biochemical correlation during management.
Methods: A prospective observational study was conducted at multispecialty government zonal hospital. Total 137
IHCP patients were managed during the study period from 01 Jan 2017 to 30 Jun 2019. Incidence and pregnancy
outcome in form of several maternal and fetal factors were analysed by appropriate statistical test using spps software
version 20.0.
Results: During the study period total 4872 patients were undergoing delivery and 137 patients were diagnosed with
IHCP. The incidence of IHCP was 2.81%. Majority of cases 75 out 137 (54.74%) were nulligravida. Total 29.92%
(41/137) cases were underwent LSCS delivery and of this 21.17% (29/137) were primary caesarean delivery. There
were three still birth noted in IHCP study population. Total 28 cases (20.44%) of IHCP were presented with preterm
labour. And NICU admissions of the study population were 32 new born babies (23.36%). 2.18% case of still birth
was noted among study population.
Conclusions: IHCP causes significant maternal and neonatal morbidity and is major contributor of preterm delivery,
caesarean delivery, meconium stained liquor and NICU admission.
Keywords: Antenatal care, Intrahepatic cholestasis of pregnancy, Obstetric choloestasis
Department of Obstetrics and Gynecology, 166 Military Hospital, Jammu, Jammu and Kashmir, India
Received: 11 November 2019
Accepted: 03 December 2019
*Correspondence:
Dr. Debkalyan Maji,
E-mail: dr.debkalyan@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196041