NEONATAL OUTCOME IN OBSTETRIC CHOLESTASIS PATIENTS AT AYUB TEACHING HOSPITAL ABBOTTABAD
Abstract
Background: Obstetric cholestasis is a liver disease specific to pregnancy characterised by pruritusaffecting the whole body but particularly the palms and soles and abnormal liver function tests.Objective of this cross sectional study was to evaluate obstetric cholestasis as a potential risk factorfor adverse neonatal outcome. The study was conducted at Department of Obstetrics andGynaecology, Unit ‘B’, Ayub Teaching Hospital, Abbottabad from April 1, 2007 to March 31, 2008.Methods: All patients presenting with obstetric cholestasis irrespective of their age and parity wereincluded in the study. Patients presenting with other causes of pruritus during pregnancy likeHepatitis (A, B, C), eczema, pruritus gravidarum and herpes gestationes were excluded from thestudy. Patients with liver involvement due to pre-eclampsia were also excluded. Baselineinvestigations, liver chemistries, viral screening, liver autoimmune screen, liver and obstetricalultrasound were all done before the diagnosis was confirmed. Patients were treated symptomatically.Neonatal outcome was calculated in terms of increased incidence of passage of meconium, pretermdelivery and foetal distress requiring delivery by Caesarean-Section. Results: Thirty patients wereselected. Babies of 10 patients did well after delivery, 8 required NICU care within first 24 hours ofbirth and rest were delivered with low APGAR score. Two babies were delivered stillborn.Conclusion: Pruritus is quite common in pregnancy with obstetric cholestasis being one of them andearlier detection of the disease allows better identification of foetuses at risk.Keywords: Hepatic cholestasis, Pruritus, liver Function Tests, Foetal distress.References
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