title: Frequency of intrahepatic cholestasis of pregnancy in Punjab Pakistan: A single centre study.
abstract: OBJECTIVE
  To find out the frequency of intrahepatic cholestasis of pregnancy and its identification parameters.
  
  
  METHODS
  The cross-sectional observational study was conducted in the Department of Medicine and the Department of Obstetrics, Combined Military Hospital, Kharian, from October 2013 to March 2014, and comprised all pregnant patients having symptoms suggestive of intrahepatic cholestasis which was confirmed after systemic inquiry, examination and biochemical analysis. Patients with cholestasis due to another reason, coagulopathies, thrombocytopenia and tumours were excluded. The patients were followed up till delivery to see the effects of cholestasis on mother and child.
  
  
  RESULTS
  Out of 1001 obstetric patients, 31(3.1%) had intrahepatic cholestasis of pregnancy. Pruritus was the main symptom in 25 (85%) patients followed by rash in 20 (65%). In 20 (64%) patients, labour was induced. Mode of delivery was Caesarean Section in 18 (58%) patients and 9 (29%) had postpartum haemorrhage. Regarding neonatal complications, 22 (70%) required admission to neonatal intensive care and 15 (48%) had meconium aspiration.
  
  
  CONCLUSIONS
  A high frequency of intrahepatic cholestasis of pregnancy was observed. It had significant impact on maternal and foetal health.
authors.affiliation: Department of Medicine, Gastroenterology, CMH, Kharian Cantt.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Hafeez
authors.affiliation: Department of Gynecology and Obstetrics, CMH, Kharian Cantt.
authors.forename: Asma
authors.initials: A
authors.lastname: Ansari
authors.affiliation: Department of Gynecology and Obstetrics, Mohtarma Benazir Bhutto Shaheed Hospital, Mirpur, AK.
authors.forename: Saima
authors.initials: S
authors.lastname: Parveen
authors.affiliation: Department of Medicine, Gastroenterology, Military Hospital, Rawalpindi.
authors.forename: Amjad
authors.initials: A
authors.lastname: Salamat
authors.affiliation: Department of Medicine, Dermatology, CMH Malir Karachi.
authors.forename: Anjum
authors.initials: A
authors.lastname: Aijaz
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D010154:Pakistan / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011256:Pregnancy Outcome; D011537:Pruritus / Q000453:epidemiology / Q000209:etiology
keywords: Intrahepatic cholestasis, Pregnancy liver problems, Prevalence of ICP.