Fetomaternal Outcomes in Intrahepatic Cholestasis of Pregnancy at Tertiary Care Hospital in Lahore

Abstract

Abstract: Background: Intrahepatic cholestasis in pregnant women (ICP) is a liver disease that usually reported after 24 weeks of pregnancy with both maternal and fetal complications. ICP is common in general and especially in Pakistani-Asian populations. There is still very little information about fetomaternal outcomes related to ICP in the country.

Objective: The aim of this research is to evaluate the fetomaternal outcome of women with ICP in a tertiary health care hospital in Lahore.

Materials and Methods: A hospital-based single arm prospective observational study was conducted in the Department of Obstetrics & Gynecology PRTH/RMDC Lahore from September 1, 2024, to January 30, 2025 approval from institutional review Board (Ref no. 441/2024). 78 pregnant women in 2nd or 3rd trimester diagnosed with ICP were included. Diagnosis was based on clinical and laboratory findings. Information was gathered on the predesigned proforma. MS Excel 2007 and SPSS version 26 were used for data analysis.

Result: This study has 78 participants with a mean age of 26.42 years. The majority were aged 18-24 years (38.5%), and most had a BMI between 25-29 (42.3%). 64.1% were primigravida and 64.1% had completed primary education. 53.84% delivered full term (37-40 weeks), while 33.3% delivered between 34-36 weeks. The most common pregnancy complication was emergency caesarean section (38.46%), followed by preterm delivery (20.51%). There were 7 cases (8.97%) of spontaneous preterm delivery, 5 cases (6.41%) of intrapartum fetal death, and 1 stillbirth (2.5%).

Conclusion: The findings highlight that ICP predominantly affected younger, overweight primigravida with lower educational attainment. Furthermore, the study revealed significant neonatal complications, including low birthweight, respiratory distress, and meconium-staining.