A study of obstetric cholestasis

Objective(s): To study the epidemiology and outcome of pregnancy complicated by obstetric cholestasis (OC). Methods(s): Retrospective case control study of 45 women with OC at a tertiary private hospital from November 2003 to November 2006. Statistical analysis was performed using the z test when appropriate. A p value <0.05 was considered statistically significant. Results: The incidence of OC was 8.2%. The most common symptom was generalized pruritus which appeared after 28 weeks in 73.3% cases. The cesarean section rate was 93.3%. A higher incidence of meconium staining in amniotic fluid at delivery (17.1% vs 1.1%, p<0.005) and preterm premature rupture of membranes (8.9% vs 1.1%, p<0.01) was noted without an increase in preterm delivery rate (24.4% vs 15.6%, not significant). There was no statistically significant difference in the following parameter - pathological cardiotocography, 1-5 minute Apgar score <7, intrauterine growth restriction, neonatal intensive care admission or perinatal mortality. There was no case of postpartum hemorrhage. Conclusion: The incidence of OC is high in the Indian population. Perinatal outcome is good in actively managed women, although at the cost of a high intervention rate. © 2010 Federation of Obstetrics and Gynaecological Societies of India (FOGSI).