Fetomaternal Outcome in Obstetric Cholestasis in a Tertiary Care Hospital.

Abstract

Introduction: Intrahepatic cholestasis is a potentially serious condition that can develop during the late half of pregnancy. It can increase the risk of preterm birth and stillbirth in fetus and postpartum hemorrhage in mothers. The main symptoms are severe pruritus. Since this condition is hormone-induced, it is a reversible condition and likely to recur in subsequent pregnancy. Early diagnosis, adequate treatment, and well-timed delivery are imperative for better maternal and fetal outcomes.

Materials and methods: This is a prospective observational study done in a tertiary care center, RIMS, Ranchi, Jharkhand. Data were collected from 203 affected pregnant females from July 2023 to June 2024. Proper history, examination, and investigations were done.

Results: The incidence was found to be 2.62% in our hospital. Women of 26-30 years were affected mostly (33.99%). 53.69% were from rural areas and belonged to the lower middle socioeconomic class. Primigravidae were affected more (45.81%). Jaundice was the most common complication (8.87%). Postpartum hemorrhage was observed in 8.87% of cases. 28.5% had preterm delivery. Intrauterine fetal death was seen in 4.43% and 1.97% had stillbirth in women affected with the disorder. Liver enzymes were significantly raised.

Conclusion: It affects the fetal outcome adversely, resulting in preterm birth, fetal distress, stillbirth, meconium aspiration, and respiratory distress syndrome. There is a high risk of postpartum hemorrhage in mothers. Proper counseling, investigations, and treatment with ursodeoxycholic acid will help in alleviating the symptoms and result in a better outcome for the mother and fetus. It is a self-limiting condition.