INTRAHEPATIC CHOLESTASIS OF PREGNANCY - A RETROSPECTIVE CASE-CONTROL STUDY OF PERINATAL OUTCOME

OBJECTIVES: Intrahepatic cholestasis of pregnancy has been related to a high frequency of abnormal intrapartum fetal heart rate, amniotic fl uid meconium, prematurity, and perinatal mortality. To determine wheth er these adverse perinatal outcomes could be improved with active inte rvention, we evaluated our results. STUDY DESIGN: We report a retrospe ctive case-control study of 320 consecutive patients with intrahepatic cholestasis of pregnancy management with antepartum testing and activ e intervention over a 2-year period. RESULTS: Our results indicate a h igher incidence of meconium staining in amniotic fluid at delivery (25 % vs 16%, p < 0.05) and spontaneous preterm delivery (12.1% vs 3.9%, p < 0.05), without an increase in the frequency of abnormal intrapartum fetal heart rate (12% vs 11%, not significant), 5-minute Apgar score < 7 (2.0% vs 1.0%, not significant), or perinatal mortality (18/1000 v s 13/1000, not significant). CONCLUSION: Antenatal testing and timed i ntervention of patients with intrahepatic cholestasis of pregnancy is associated with a reduction of the previously reported adverse perinat al outcomes.