Outcome of Pregnancy Complicated by Obstetric Cholestasis

BACKGROUND Pruritus is the primary clinical symptom of ICP. It may considerably impair the patient's quality of life causing sleep deprivation, psychological suffering and even suicidal thoughts. Pruritus is most severe in the evening, with a predilection for the palms of the hands and soles of the feet, and is not associated with any specific skin lesions. The main biochemical alterations are elevations of serum bile acids and aminotransferase activities. We wanted to study the outcome of pregnancy complicated by obstetric cholestasis in terms of maternal and foetal outcome. METHODS This is a prospective study done over a period of 18 months in 80 booked antenatal patients who complained of pruritus during their pregnancy. They were followed, and maternal and perinatal outcomes recorded. Appropriate statistical analysis was used for result. RESULTS Incidence of obstetric cholestasis in our hospital was 5%. Majority of the patients were primigravida (60%) and presented at gestational age between 32-36 weeks. Maternal morbidities are due to sleep disturbance (68.75%), dyslipidaemia (48.75%), deranged coagulation profile (22.5%), PPH (8.75%), increased operative interference (57.5%) and PROM ( 23.75%). Perinatal outcomes were MSL (23.75%), prematurity (25%), stillbirth (2.5%), NICU admission (18.75%), foetal distress (20%) and LBW (18.75%). Maximum number of patients were delivered between 37-38 weeks. CONCLUSIONS Active and timely intervention is needed to avoid unnecessary and early intervention and prevent the risk of prematurity.