Study to Determine the Incidence and Pregnancy Outcomes in Women With Obstetric Cholestasis in a Tertiary Care Centre

Abstract

Background: Obstetric cholestasis is the most common liver disorder during pregnancy which normally presents in the second half of pregnancy. The present study has made an effort to determine the incidence and pregnancy outcomes in women with obstetric Cholestasis. Aims and Objectives: To determine the incidence and analyse pregnancy outcome in women with obstetric cholestasis. Methodology: Cross Sectional Prospective Study. Results: The incidence of obstetric cholestasis hence was found to be 2%.Most of the patients belonged to age group 20-24 years. (52.86%), of gestational age 32-36 weeks at diagnosis (67.14%), of >36 weeks gestational age at delivery (64.29% ), mostly primigravida ( 64.29%) and non smoker (92.86%).47.14% Patients had vaginal delivery of which 12.5% was spontaneous, 16.25% was induced, and 12.5% was instrumental.52.86% patients delivered by lower segment caesarean section of which 12.5% was elective, 6.25% was due to failed induction, and 15% was due to meconium stained liquor and foetal distress. 54.29% patients got relief from pruritus in 1 week of administration of UDCA. Regarding complications, about 15.71% landed in postpartum hemorrhage, 11.42% had altered coagulation profile, 35.71% had preterm labour, 24.29% had altered lipid profile and 17.14% had insomnia. 21.4% of babies had low birth weight, 35.71% were preterm, 30% small for gestational age, 15.71% had abnormal CTG, 48.57% had meconium stained liquor,11.42% had respiratory distress, 21.4% needed NICU admission and 1.43% had intrauterine death. Conclusion: Considering the adverse effects on foetus, pregnant women should be judiciously followed through the antenatal period till delivery. Decision regarding early induction should be taken considering risk of prematurity, low birth weight and NICU admission.