American Journal of Obstetrics and Gynecology
Intrahepatic cholestasis of pregnancy: Perinatal outcome associated with expectant management☆,☆☆,★
Section snippets
MATERIAL AND METHODS
We reviewed the medical records of all patients who underwent antepartum testing for intrahepatic cholestasis of pregnancy at Los Angeles County/University of Southern California Medical Center over a 7-year period (1988 through 1995). The diagnosis of intrahepatic cholestasis of pregnancy was based on the presence of generalized pruritus in the absence of other skin or medical conditions that could produce pruritus. When suspected, viral hepatitis and obstructive gallstones were excluded with
RESULTS
During the study period 79 patients underwent antepartum testing for intrahepatic cholestasis of pregnancy, and management was undertaken as described. Seventy-nine consecutive patients who underwent antepartum testing for a history of unexplained fetal death were used as a control group. There was no significant difference between the two groups in maternal age; however, the control patients had higher parity because none was primigravid. Labor induction was more common in control patients
COMMENT
The role of antepartum testing in the management of pregnancies complicated by intrahepatic cholestasis of pregnancy is unclear. We used antepartum testing in the management of such patients, but it did not successfully predict fetal compromise, as shown by two intrauterine fetal deaths within 5 days of a normal nonstress test result. The two fetal deaths observed in the cholestasis group correspond to a perinatal mortality rate of 25 per 1000. Because of the limited number of cholestasis
References (20)
- et al.
Obstetric cholestasis: a 14-year review
Am J Obstet Gynecol
(1979) - et al.
Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome
Am J Obstet Gynecol
(1994) - et al.
The modified biophysical profile: antepartum testing in the 1990s
Am J Obstet Gynecol
(1996) - et al.
A prospective study of 18 patients with cholestasis of pregnancy
Am J Obstet Gynecol
(1982) - et al.
Liver diseases in pregnancy
Histopathology
(1986) - et al.
Liver diseases unique to pregnancy
Am J Gastroenterol
(1991) A study of recurrent jaundice in pregnancy
Acta Obstet Gynecol Scand
(1954)- et al.
Cholestasis of pregnancy: clinical and laboratory studies
Acta Obstet Gynecol Scand
(1986) The enigma of intrahepatic cholestasis of pregnancy: lessons from Chile
Hepatology
(1982)- et al.
Serum bile acid concentrations during pregnancy and their relationship to obstetric cholestasis
Gastroenterology
(1986)
Cited by (0)
- ☆
From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California School of Medicine.
- ☆☆
Reprint requests: Owaidah M. Alsulyman, MD, Room 5K40, Women's and Children's Hospital, 1240 N. Mission Road, Los Angeles, CA 90033.
- ★
0002-9378/96 $5.00 + 0 6/6/75294