Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome.
OBJECTIVE
Intrahepatic cholestasis of pregnancy has been related to a high frequency of abnormal intrapartum fetal heart rate, amniotic fluid meconium, prematurity, and perinatal mortality. To determine whether these adverse perinatal outcomes could be improved with active intervention, we evaluated our results.


METHODS
We report a retrospective case-control study of 320 consecutive patients with intrahepatic cholestasis of pregnancy management with antepartum testing and active intervention over a 2-year period.


RESULTS
Our results indicate a higher incidence of meconium staining in amniotic fluid at delivery (25% vs 16%, p < 0.05) and spontaneous preterm delivery (12.1% vs 3.9%, p < 0.05), without an increase in the frequency of abnormal intrapartum fetal heart rate (12% vs 11%, not significant), 5-minute Apgar score < 7 (2.0% vs 1.0%, not significant), or perinatal mortality (18/1000 vs 13/1000, not significant).


CONCLUSIONS
Antenatal testing and timed intervention of patients with intrahepatic cholestasis of pregnancy is associated with a reduction of the previously reported adverse perinatal outcomes.
Rioseco
A J
AJ
Department of Obstetrics and Gynecology, Pontificia Universidad Católica de Chile School of Medicine, Santiago.
Ivankovic
M B
MB
Manzur
A
A
Hamed
F
F
Kato
S R
SR
Parer
J T
JT
Germain
A M
AM
D000328:Adult; D002585:Cesarean Section; D002780:Cholestasis, Intrahepatic / Q000150:complications*; D005260:Female; D005313:Fetal Death; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies