Evaluation of bile acid and deranged liver function test in obstetrics cholestasis in pregnancy in fetal and perinatal outcome

Authors

  • Poonam Mani Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Rishika Sachdeva Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Neeta Chaudhary Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Nikshima Chhabra Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231915

Keywords:

Intrahepatic cholestasis, Gamma glatmine transferase, Meconium stained liquor, Serum glutamic pyruvic transaminase and oxaloacetic transaminase

Abstract

Background: Pregnancy-related intrahepatic cholestasis is most prevalent hepatic disorder intense pruritus that affects the entire body including palm and sole. It is typically detected during second or third trimester. Pruritus frequently exacerbates at night, marked on the palms and soles of the feet and hands. Aim of this study was to evaluate bile acid and deranged liver function test in obstetrics cholestasis in pregnancy and to determine maternal fetal and outcomes.

Methods: This prospective case series study was conducted in the Department of Obstetrics and Gynaecology, Muzaffarnagar Medical College. The present study was conducted in 50 women, who were selected from outpatient department of antenatal care from tertiary care, taken written permission before study. The medical records of all women with obstetrics cholestasis who delivered between December 2021and August 2022.

Results: Subjects with IHCP  has mean age of 30.11±5.03 year, found SGOT 40% in 100-200  and SGPT 44 % I (0-100) range  and total bilirubin levels   is 33 %  in IHCP patients. In study found that LSCS due to 24% in fetal distress, 36% in MSL, 16% in IUGR, 14% preterm. Participants have 22% birth weight <2.5kg and 39 (78%) are under >2.5kg  babies  in IHCP patients and 24 % were underwent fetal distress and  24 % preterm delivery and 6 % got IUD . and no stillborn and 12% meconium.

Conclusions: It causes maternal pruritus with impaired LFT and raised serum bile acids. Maternal morbidity is increased in terms of increased LSCS rates and discomfort due to pruritus.

References

Banotra P, Lone FA, Malik LA and Sharma S. Maternal outcome in cholestasis of pregnancy in patients. Inter J Curr Res. 2018;10(10):74734-7.

Mohan M, Antonios A, Konje J, Lindow S, Syed MA, Akobeng A. Stillbirth and associated perinatal outcomes in obstetric cholestasis: a systematic review and meta-analysis of observational studies. Eur J Obstet Gynecol Reprod Biol: X X. 2019;3:100026.

Vijay C, Thomas A, Anand S, Ramesh N. Perinatal Outcomes among Women with Cholestasis of Pregnancy. J South Asian Feder Obst Gynae. 2020;12(5):295-301.

Arthuis C, Diguisto C, Lorphelin H, Dochez V, Simon E, Perrotin F, et al. Perinatal outcomes of intrahepatic cholestasis during pregnancy: An 8-year case-control study. PLoS One. 2020;15(2) e0228213.

Dang A, Agarwal N, Bathla S, Sharma N, Balani S. Prevalence of liver disease in pregnancy and its outcome with emphasis on obstetric cholestasis: An Indian scenario. J Obs Gynecol India. 2010;60:413-8.

Cardoso Pia. A Study of obstetric cholestasis in goa medical college. IOSR. 2020;19:28-32.

Posh S, Ajaz S, Jeelani B, Khurshid R. Impact of obstetric cholestasis on fetal outcome-An observational study. J Sci Soc 2020;47(1):28-32.

Mitra B, Maji D, Borse DS. A study on feto-maternal outcome of intra hepatic cholestasis of pregnancy. Int J Reprod Contracept Obstet Gynecol 2020;9(1):318-22.

Wolf MF, Sgayer I, Yaron L, Shnaider O, Odeh M, Bornstein J, Carmiel M. Intrahepatic cholestasis of pregnancy - prevalence and ethnic distribution in northern Israel. Ginekol Pol. 2022;93(7):578-84.

Jhirwal M, Sharma C, Shekhar S, Singh P, Meena SP, Kathuria P, Tak A. Maternal and Perinatal Outcome in pregnancy complicated by intrahepatic cholestasis. Cureus. 2022 Aug 28;14(8).

Yadav S, Goel A, Lingaiah R, Pradhan M, Katiyar H, Aggarwal R. serum bile acid levels in women with intrahepatic cholestasis of pregnancy in India. J Clin Experi Hepatol. 2022;12(2):379-83.

Das S, Roy A. A Study on Intrahepatic Cholestasis in Pregnancy to Evaluate Risk factors for Adverse Perinatal Outcome: An Experience from a Tertiary Care Center of East India. J Med Sci Heal. 20121;6:7-13.

Jamwal D, Kour G, Mehta A. Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India. Int J Reprod Contracep Obstet Gynecol. 2021;10(7):2830-5.

Kant A, Goswami S, Gupta U, Razdan A, Amle D. Maternal and perinatal outcome in cholestasis of pregnancy: a study in tertiary care hospital in North India. Int J Reprod Contracep Obstet Gynecol. 2018;7(12):5066-71.

Downloads

Published

2023-06-28

Issue

Section

Original Research Articles