ANTEPARTUM FETAL CEREBRAL-HEMORRHAGE NOT PREDICTED BY CURRENT SURVEILLANCE METHODS IN CHOLESTASIS OF PREGNANCY

Background: The reason for increased fetal mortality in cholestasis of pregnancy is not completely understood. Intracerebral hemorrhage due to coagulation disorders, similar to those reported in the mother, is a possible explanation. Case: Antepartum fetal death occurred at 37 we eks in a primigravida with cholestasis of pregnancy. The woman was tak ing no medication. Autopsy revealed extensive cerebral hemorrhage. A c ardiotocogram and biophysical profile performed 24 hours and 5 days, r espectively, before fetal death had been normal. Conclusion: Antepartu m fetal death may occur in patients with mild cholestasis who are taki ng no medication. Intracerebral hemorrhage is a possible cause, and th is may be unpredictable with current methods of fetal surveillance. Th is possibility constitutes an argument in support of delivering these pregnancies as soon as lung maturity is achieved. (C) 1997 by The Amer ican College of Obstetricians and Gynecologists.