The effect of intrahepatic cholestasis of pregnancy on maternal and perinatal outcomes

Abstract

Objective: To evaluate maternal and perinatal outcomes of the pregnancies complicated by intrahepatic cholestasis of pregnancy and to discuss the appropriate pregnancy management

Material and Method: Maternal and fetal characteristics were analyzed from the medical records of 32 patients who gave birth following a pregnancy complicated with intrahepatic cholestasis of pregnancy between January 2009 and December 2013.

Results: A total of 32 patients with intrahepatic cholestasis of pregnancy were enrolled the study. Diagnosis of intrahepatic cholestasis was made at an average of 34.15±3.1 gestational weeks and mean gestational time at birth was found to be 37.4±1.86 gestational weeks.  Preterm birth rate (<37 gestational weeks) was 20.59%. Mean birth weight and  a low (<7) 5- minute APGAR score were 2980±480g., and 14.70%, respectively. Meconium was detected in amniotic fluid in 14.70 % of the cases and admission rate to neonatal care unit was 12.50 %. There were no reported cases of stillbirth. The incidence of gestational diabetes mellitus in intrahepatic cholestasis of pregnancy was 15.62%.

Conclusion: Our data confirm an increased risk of preterm delivery in intrahepatic cholestasis of pregnancy. The high rates of  gestational diabetes mellitusis need to be considered in the management of intrahepatic cholestasis of pregnancy.

Keywords

• Intrahepatik cholestasis of pregnancy
• maternal and perinatal outcomes
• gestational diabetes mellitus

Gebeliğin intrahepatik kolestazının maternal ve perinatal sonuçlara etkisinin değerlendirilmesi

Öz

Amaç: Gebeliğin intrahepatik kolestazı tanısıyla takip edilen hastaların maternal ve perinatal sonuçlarının değerlendirilmesi ve uygun gebelik yönetiminin tartışılması amaçlandı.

Gereç ve Yöntem: Ocak 2009 ve Aralık 2013 yılları arasında gebeliğin intrahepatik kolestazı tanısı alan 32 hastanın dosyalarına retrospektif olarak ulaşılarak maternal ve perinatal sonuçlar açısından analiz edildi.

Bulgular: Toplam 32 hasta çalışmaya dahil edildi. Gebeliğin intrahepatik kolestazı ortalama tanı haftası 34,15±3,1 ve ortalama doğum haftası 37,4±1,86 hafta olarak bulundu. Preterm doğum oranı (doğumda gebelik haftası<37) %20,59 (7/34 yenidoğan) olarak saptandı. Ortalama doğum ağırlığı 2980±480 gram idi. Yenidoğanların %14,7’nin doğumda 5. dakika APGAR skorunun 7’nin altında olduğu izlendi. Yenidoğanların %14,7’sinde amnion mayisinde mekonyum pasajı izlendi. Dört (%12,5) yenidoğanın yoğun bakım ünitesine gönderilme gereksinimi oldu. Perinatal mortalite saptanmadı. Gebeliğin intrahepatik kolestazı tanılı hastalarda gestasyonel diyabetes mellitus insidansının %15,6 olduğu izlendi.

Sonuç: Çalışmamız gebeliğin intrahepatik kolestazı tanılı gebelerde preterm doğum riskinin arttığını doğrulamaktadır. Gebeliğin intrahepatik kolestazı tanılı hastalarda gestasyonel diyabetes mellitus riskinin artmış olması da hastalığın yönetiminde dikkate alınması gereken bir durum olduğunu düşünmekteyiz.

Anahtar Kelimeler

• Gebeliğin intrahepatik kolestazı
• maternal ve perinatal sonuçlar
• gestasyonel diyabetes mellitus

Kaynakça

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