Current Medicine Research and Practice (Jan 2012)
Intrahepatic cholestasis of pregnancy: Prevalence and perinatal outcome
Abstract
Background: Intrahepatic cholestasis of pregnancy (IHCP) is characterized by itching with or without icterus in pregnant women. IHCP is likely to be associated with adverse perinatal outcomes. Objective: This study was conducted at Sir Ganga Ram Hospital to determine the prevalence of IHCP and to evaluate the associated perinatal outcome among pregnant women during a period of 1 year (1 January 2003 to 31 December 2003). Methods: All pregnant women with pruritus and/or jaundice were enrolled as study subjects. The patients without these symptoms were classified as controls. The enrolled subjects were studied in terms of demographic data and pregnancy outcome measures, such as preterm-birth, low birth-weight, operative intervention for fetal distress, meconium staining of amniotic fluid, Apgar score, transfer to the neonatal intensive care unit (NICU) with a resultant stay and the perinatal deaths. Results: Among the 2195 patients delivering during the study period, a total of 73 (3.3%) patients had IHCP. The mean gestational age and birth weight in patients with and without IHCP were 37.6±2.4 vs. 36.6±1.41 days (p=0.218) and 2.58±0.47 vs. 2.78±0.56 kg (p=0.695), respectively. There was a 4.3-fold increased occurrence of meconium staining of amniotic fluid in the IHCP group (25.3% vs. 5.8%, p<0.001). Operative interventions for fetal distress were significantly higher in the IHCP group (41.3% vs. 18.2%, p<0.001). The perinatal mortality in patients with or without IHCP was comparable (2.7% vs. 1.4%, p=0.361). There were significantly increased transfers of the neonates to the NICU in the IHCP group (41.3% vs. 21.2%, p<0.001). However, the mean duration of stay in the neonatal unit was comparable. Conclusion: IHCP is a benign disease from maternal point of view, but has shown to adversely affect the perinatal outcome.
