title: Obstetric Outcome During an Era of Active Management for Obstetrics Cholestasis.
abstract: OBJECTIVE
  To study the incidence, maternal, and perinatal outcomes in intrahepatic cholestasis of pregnancy with active management.
  
  
  METHODS
  This observational study included 48 cases diagnosed as intrahepatic cholestasis of pregnancy. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcomes are studied.
  
  
  RESULTS
  Incidence of ICP was 2.4 %. More than 86 % of patients presented with generalized pruritus mostly after 30 weeks. Incidences of Intrapartum abnormal cardiotocography (12.5 %) and thick meconium (8.33 %) were high. Cesarean section rate was high (41.66 %). Most common indications were CDMR, fetal distress, and non-progress of labor. Incidence of preterm labor, IUGR, Apgar score (<7), and neonatal admission rate were not high. There was one stillbirth at 36 weeks of gestation. Serum transaminase levels tended to be higher in patients with poor perinatal outcomes, such as stillbirth, fetal distress, and meconium-stained amniotic fluid.
  
  
  CONCLUSIONS
  Serum transaminase levels tended to be higher in patients with poor perinatal outcome. Perinatal outcome is good with active management, at the cost of higher LSCS rate. Further randomized controlled trial of early versus spontaneous delivery may be justified.
authors.affiliation: Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya 793018 India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya 793018 India.
authors.forename: S
authors.initials: S
authors.lastname: Panda
authors.affiliation: Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya 793018 India.
authors.forename: Ahanthem Santa
authors.initials: AS
authors.lastname: Singh
keywords: Active management; Intrahepatic cholestasis of pregnancy; Obstetrics cholestasis; Perinatal outcome