Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Dodampahala, Senani Hemantha; Pieris, Hemantha; Chandrasena, Lal Gotabaya; Jayakody, Surangi; Gunathilaka, Chamara; Wijayaratne, Chandrika Neelakanthi; Dodampahala, Gayani Sandamali Kotuwegedara; Meegahawatta, A. R.

doi:10.4236/arsci.2016.42006

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…All patients with deranged coagulation were given Vitamin K injection on three consecutive days and few patients in whom Sr. Bilirubin was raised, FFP was administered. The rate of PPH in present study was 8.75% which is comparable to those observed by Medda et al 16 (10%) and Ghimire et al 19 (11.25%) whereas Dodampahala et al 24 (29.6%) and Mahajan et al 21 (16%) observed higher rates of PPH. PPH was less in present study due to active management of ICP cases with earlier UDCA prescription and administration of Vit K injection and FFP in some cases.…”

Section: Discussionsupporting

confidence: 85%

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Nisha¹,

Singh²,

Kumari³

2019

jemds

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BACKGROUND Pruritus is the primary clinical symptom of ICP. It may considerably impair the patient's quality of life causing sleep deprivation, psychological suffering and even suicidal thoughts. Pruritus is most severe in the evening, with a predilection for the palms of the hands and soles of the feet, and is not associated with any specific skin lesions. The main biochemical alterations are elevations of serum bile acids and aminotransferase activities. We wanted to study the outcome of pregnancy complicated by obstetric cholestasis in terms of maternal and foetal outcome. METHODS This is a prospective study done over a period of 18 months in 80 booked antenatal patients who complained of pruritus during their pregnancy. They were followed, and maternal and perinatal outcomes recorded. Appropriate statistical analysis was used for result. RESULTS Incidence of obstetric cholestasis in our hospital was 5%. Majority of the patients were primigravida (60%) and presented at gestational age between 32-36 weeks. Maternal morbidities are due to sleep disturbance (68.75%), dyslipidaemia (48.75%), deranged coagulation profile (22.5%), PPH (8.75%), increased operative interference (57.5%) and PROM (23.75%). Perinatal outcomes were MSL (23.75%), prematurity (25%), stillbirth (2.5%), NICU admission (18.75%), foetal distress (20%) and LBW (18.75%). Maximum number of patients were delivered between 37-38 weeks. CONCLUSIONS Active and timely intervention is needed to avoid unnecessary and early intervention and prevent the risk of prematurity.

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Section: Discussionsupporting

confidence: 85%

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Nisha¹,

Singh²,

Kumari³

2019

jemds

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“…ICP is associated with increased risks of stillbirths, respiratory distress syndrome, meconium passage, and fetal asphyxiation [ 4 ]. ICP was associated with delivery before 37 gestational weeks, generalized pruritus of the palms and soles, postpartum hemorrhage, meconium-stained liquor, placental abruption, preterm labor, bleeding manifestation, fetal distress, and cord prolapse [ 5 ]. Postpartum hemorrhage and placental abruption displayed the most significant increases in those with ICP.…”

Section: Introductionmentioning

confidence: 99%

Placental Abruption and Partial Placental Prolapse During Induction of Labor in a 31-Year-Old Female With Intrahepatic Cholestasis of Pregnancy: A Case Report

Dick¹,

Brotman²

2022

Cureus

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Placental abruption during induction of labor in females with intrahepatic cholestasis of pregnancy is not exceptionally common and there are no documented reports of placental prolapse following abruption in the literature. The aim of this study is to discuss the possibility of placental abruption and partial prolapse of a low-lying placenta during a prolonged induction of labor in a female with recurrent intrahepatic cholestasis of pregnancy following a cholecystectomy. We describe a 31-year-old G4P3003 female with recurrent intrahepatic cholestasis of pregnancy, with no family history of the condition and surgical history of cholecystectomy, whose induction of labor at 37+3/7 gestational weeks for intrahepatic cholestasis of pregnancy was complicated by placental abruption and partial prolapse of the low-lying placenta. Emergency cesarean section was required for the delivery of her healthy baby. Postpartum was complicated by severe postpartum hemorrhage, post-hemorrhagic anemia, hypotension, blood transfusion reaction, endometritis, and pneumonia. The pathophysiology of intrahepatic cholestasis of pregnancy is not fully understood. Intrahepatic cholestasis of pregnancy increases maternal morbidity, may reoccur in subsequent pregnancies, and is associated with adverse perinatal outcomes. Timely intervention at 37-38 gestational weeks can reduce adverse fetal and maternal outcomes. This case report supports the possibility of 1) a correlation between cholecystectomy and the continued recurrence of intrahepatic cholestasis of pregnancy, 2) placental abruption, and 3) partial prolapse of a low-lying placenta, related to the induction of labor in females with intrahepatic cholestasis of pregnancy. Thus, encouraging further studies to facilitate a greater level of understanding.

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Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Cited by 2 publications

References 23 publications

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Outcome of Pregnancy Complicated by Obstetric Cholestasis

Placental Abruption and Partial Placental Prolapse During Induction of Labor in a 31-Year-Old Female With Intrahepatic Cholestasis of Pregnancy: A Case Report

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