Operative delivery rates following induction of labour for obstetric cholestasis

Webster, Jessica R; Chappell, Lucy C; Cheng, Floria; Breeze, Andrew C. G.; Lucas, Nuala; Plaat, F.; Williamson, Catherine

doi:10.1258/om.2011.110080

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…Another retrospective case-control study of 64 inductions of labour due to ICP revealed no increased risk of vaginal surgical delivery or caesarean section. Other complication rates, e.g., for postpartum haemorrhage, were comparable to the control group of induced labour without ICP 159 .…”

Section: Delivery Managementmentioning

confidence: 62%

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Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Hagenbeck

Hamza

Kehl

et al. 2021

Geburtshilfe Frauenheilkd.

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Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease specific to pregnancy. The cardinal symptom of pruritus and a concomitant elevated level of bile acids in the serum and/or alanine aminotransferase (ALT) are suggestive for the diagnosis. Overall, the maternal prognosis is good. The fetal outcome depends on the bile acid level. ICP is associated with increased risks for adverse perinatal outcomes, including preterm delivery, meconium-stained amniotic fluid, and stillbirth. Acute fetal asphyxia and not chronic uteroplacental dysfunction leads to stillbirth. Therefore, predictive fetal monitoring is not possible. While medication with ursodeoxycholic acid (UDCA) improves pruritus, it has not been shown to affect fetal outcome. The indication for induction of labour depends on bile acid levels and gestational age. There is a high risk of recurrence in subsequent pregnancies.

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Section: Delivery Managementmentioning

confidence: 62%

“…Die weitere Komplikationsrate z. B. für postpartale Blutung war vergleichbar zur Kontrollgruppe aus Geburtseinleitungen ohne ICP 159 .…”

Section: Entbindungsmodusunclassified

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Hagenbeck

Hamza

Kehl

et al. 2021

Geburtshilfe Frauenheilkd.

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show abstract

“…Serum bile acid concentrations over 40 µmol/L as high-risk pregnancy with ICP; no difference is observed in modes of delivery of pregnancies that are terminated at the 37th gestational week [20]. In a retrospective study, there was no increase in intervention delivery or cesarean delivery rates in women with ICP [21]. Also, no difference was observed in terms of the first and second stage of the delivery periods of pregnant women with ICP compared with the control group.…”

Section: Discussionmentioning

confidence: 89%

The severity of intrahepatic cholestasis of pregnancy can shorten the first stage of labor in multiparous women induced by prostaglandin E2

et al. 2020

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Aim: To determine the relationship between increased serum bile acid concentrations and the first stage of labor in multiparous women induced by vaginal prostaglandin E2 (PGE2) with intrahepatic cholestasis of pregnancy (ICP). Material and Methods: In this retrospective case-control study 283 multiparous women with ICP and 283 healthy multiparous pregnant women were admitted for induction of delivery, were inserted PGE2 (10 mg dinoprostone) vaginally. The groups with mild, moderate and severe ICP were compared with control group in terms of the time from beginning of PGE2 vaginal insertion to active phase of labor, the time from beginning of PGE2 vaginal insertion to complete dilatation of cervix and fetal outcomes. Results: The time from beginning of PGE2 insertion to active phase in the mild, moderate and severe ICP groups were shorter than in the non-ICP group; 3.19±0.32, 7.26±0.34, 8.71±0.35 hours, respectively (p<0.01). The time from beginning of PGE2 insertion to complete dilatation of cervix in the groups with mild, moderate and severe ICP were shorter than in non-ICP group; 3.03 ± 0.45; 10.33 ± 0.62; 14.44 ± 0.53, respectively (p<0.01). There was no difference between the groups in terms of fetal outcomes except fetal weight and the presence of meconium (p<0.01). Conclusion: Increased bile acid concentrations in multiparous pregnant women induced by vaginal PGE2 with mild, moderate and severe ICP are associated with shorter duration of cervical ripening and labor induction time to delivery. The study concluded that multiparous women with ICP can deliver faster as the severity of cholestasis increases.

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“…Regular check-ins and diagnostic lab tests are a part of maternal monitoring (bile acids, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, bilirubin, and prothrombin time). Pregnancy monitoring should primarily use cardiotocography (CTG) and ultrasound screening, with intervals determined by the mother's pre-existing conditions and the total bile acid level [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic Cholestasis of Pregnancy: A Case Report of Third-Trimester Onset of the Disease

Bakhsh¹,

Elawad²,

Alqahtani³

et al. 2022

Cureus

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Intrahepatic cholestasis of pregnancy (ICP) is characterized by pruritus and an elevation in serum bile acid concentrations, typically developing in the late second and/or the third trimester and rapidly resolving after delivery. ICP is a rare condition that most often presents in the late second or early third trimesters of pregnancy. Physicians should be aware of this unusual presentation of ICP and screen their patients appropriately during prenatal consultations by monitoring symptom severity and laboratory tests, including bile acids and liver enzyme levels, in addition to monitoring the fetal condition to start treatment modality including maternal treatment and determine the time of delivery to avoid fetal complications. This is a case of severe ICP diagnosed in the late second trimester and went into labor at 33 weeks of gestational age.

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Operative delivery rates following induction of labour for obstetric cholestasis

Cited by 14 publications

References 18 publications

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine – Section on Maternal Disorders

The severity of intrahepatic cholestasis of pregnancy can shorten the first stage of labor in multiparous women induced by prostaglandin E2

Intrahepatic Cholestasis of Pregnancy: A Case Report of Third-Trimester Onset of the Disease

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