DIAGNOSIS AND NEONATAL OUTCOME IN OBSTETRIC CHOLESTASIS
DOI:
https://doi.org/10.69656/pjp.v12i1.415Keywords:
Gestational Cholestasis, Pruritis, Liver function test, Foetal OutcomeAbstract
Background: Gestational cholestasis can cause preterm delivery, meconium staining of liquor, foetal distress, intrauterine foetal death, Respiratory Distress Syndrome and NICU admission. Fetomaternal surveillance can be done by serial assessments of serum bile acid (SBA) levels, liver function tests, foetal kick count chart, foetal cardio-tocography and serial ultrasound assessments along with routine antinatal care. This retrospective study was conducted to find alternative methods of foetal surveillance in case of non availability of SBA assessment. Method: This study was conducted at AERO Hospital, Hasanabdal from Jan 2013 to Jul 2015, and 69 patients aged 18–40 years with gestational cholestasis and singleton pregnancy after excluding other causes of pruritis and deranged liver function tests were included in study and above mentioned parameters assessed. All patients were administered Ursodeoxycholic acid and Dexamethasone 12 mg, two doses 12 hours apart. Results: Twenty-five percent patients underwent preterm delivery, 25% had meconium stained liquor, 2.8% had intrauterine death, and 1.4% had early neonatal death. Greater the grade of pruritis and higher the abnormality of ALT were, the higher the incidence of foetal complication was. Conclusion: Pregnancies with getational cholestasis monitored in this way have reasonably good foetal outcome even in the absence of SBA monitoring but required more frequent visits by mothers and vigilance of obstetrician.
Paj J Physiol 2016;12(1):15–7
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