Maternal and Fetal Outcome in Pregnancy Complicated by Intrahepatic Cholestasis of Pregnancy: A Hospital-based Study

Aim and background: Intrahepatic cholestasis of pregnancy (IHCP) is a liver disorder unique to pregnancy, marked by itching without rash, increased liver enzymes, and disrupted bile acid metabolism.The reported incidence is approximately 1.2-1.5% of pregnancies.Frequent nighttime itching of the palms and soles without skin lesions may suggest IHCP.Serum bile acid levels serve as a sensitive and specific marker for IHCP.This study was conducted to assess the maternal and fetal outcomes in pregnant patients with IHCP.Materials and methods: This prospective observational study took place in the obstetrics and gynecology department at SKIMS MC Bemina over the course of one year, monitoring women with IHCP through term and postpartum to evaluate maternal and fetal outcomes.Results: Out of 200 patients, 134 had mild IHCP, and 10 developed severe IHCP.12 patients had a preterm delivery, 88 patients delivered vaginally, and 112 patients delivered via a cesarean section.Forty-six patients had maternal complications -PROM, postpartum hemorrhage (PPH), and coagulopathies.Fetal complications were seen in 77 pregnancies.Conclusion: Intrahepatic cholestasis of pregnancy is associated with adverse fetal and maternal outcomes.Management involves early detection during the antenatal period, thorough evaluation and treatment in the peripartum period with comprehensive baseline and specific investigations, as well as regular antenatal check-ups and follow-up.