Fetomaternal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis

Abstract

Intrahepatic cholestasis of pregnancy (IHCP) is a liver disorder unique to pregnancy, characterized by pruritus and elevated serum bile acids. IHCP is associated with increased risk of adverse fetomaternal outcomes, including preterm birth, fetal distress, and stillbirth. Early diagnosis and management are crucial to reduce complications. Objectives: The study aimed to determine the frequency and severity of IHCP in pregnant women and to compare fetomaternal outcomes among mild, moderate, and severe IHCP cases. Methods: Ninety. This cross-sectional study was conducted at the Department of Gynecology, Rawalpindi Teaching Hospital, Rawalpindi, from February 28, 2025, to May 28, 2025. -Five pregnant women with singleton pregnancies beyond 28 weeks were enrolled using consecutive sampling. Diagnosis of IHCP was based on pruritus, fasting serum bile acids >19 µmol/L, and elevated liver enzymes. Patients were managed with ursodeoxycholic acid and followed with routine antenatal assessments. Maternal outcomes (preterm labor, postpartum hemorrhage, preeclampsia) and fetal outcomes (preterm birth, meconium-stained liquor, fetal distress, IUD, NICU admission) were recorded. Data were analyzed using SPSS v25; categorical variables were presented as n (%) and compared using chi-square tests. Results: IHCP was observed in 13.7% of participants, with mild, moderate, and severe cases accounting for 69.2%, 23.1%, and 7.7%, respectively. Maternal complications occurred in 46.2% of IHCP cases, while fetal complications were noted in 69.2%. Preterm birth and NICU admissions increased with the severity of IHCP. Stratification showed no significant differences in IHCP prevalence with respect to age, parity, or gestational age. Conclusion: IHCP was associated with considerable fetomaternal risks, which increased with severity. Close monitoring and timely management are crucial for improving outcomes.