PERINATAL OUTCOME IN PREGNANCY COMPLICATED BY OBSTETRIC CHOLESTASIS AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

Abstract

Aim:To determine the perinatal outcome in pregnancy complicated by obstetric cholestasis. Study type, Setting, duration: This descriptive study was conducted in Obstetrics and Gynaecology Department of SKMCH, Muzaffarpur, Bihar from September 2019 to August 2020. Methods: All the pregnant ladies who were diagnosed as having obstetric cholestasis and delivered during the study period were included in the study. Variables studied included age, parity, gestational age of appearance of symptoms, sign /symptoms, liver function tests, mode of delivery and fetal outcome. Information was collected on a predesigned questionnaire. SPSS version 15 was used for analysis. Results: Total 1250 patients were delivered in this hospital during the study period. Out of these 35 cases [2.8%] were diagnosed to have obstetric cholestasis. The mean age of subjects was 26.4 years. The data of parity showed 15(42.8%) were primigravida and 20(57.1%) were multi gravida. The most common presenting symptom was pruritis (91.4%).Gestational age at which symptoms appeared first was 34-36 weeks in 22 patients (65.8%),32-34 weeks in 5 cases (14.4%),before 32 weeks in 4 cases (11.4%)and 37 week in 3 cases(8.6%).Out of 35 cases 15 patients (42.8%) had normal vaginal delivery and 20 patients (57.2%)were delivered by cesarean section. Perinatal outcome revealed 10 babies (28.5%)were meconium stained,6 babies(17.1%) showed abnormal CTG pattern. Intrauterine growth retardation was seen in 6(17.1%) and prematurity in 9 cases(25.8%).Intrauterine death occurred in 1 patient(2.8%). Conclusion: Cholestasis of pregnancy has adverse effects on perinatal outcome, hence early diagnoses, vigilant follow up and timely delivery is essential.