Retrospective analysis of maternal, fetal, and neonatal outcomes of intrahepatic cholestasis of pregnancy at Gazi University

Authors: BERRİN GÜNAYDIN, MERİH BAYRAM, MELİS ALTUĞ, SEMRA CEVHER, NURAY BOZKURT

Abstract: Background/aim: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period. Materials and methods: After ethics committee approval, data from 1 January to 31 December 2015 were collected to identify parturients with ICP. Results: Ten out of 37 patients underwent normal spontaneous vaginal delivery (NSVD), and the remaining 27 parturients underwent cesarean section (CS). Five of 27 parturients underwent nonelective cesarean section, while 22 had elective cesarean delivery. As for NSVD deliveries, only one parturient received combined spinal and epidural anesthesia (CSE) for labor. Neuraxial (n = 22 for spinal and n = 1 for CSE) and general anesthesia (n = 4) rates for CSs were 85% and 15%, respectively. Approximately 96% of neuraxial anesthesia choices were spinal anesthesia. Nearly 18.5% of CSs were not elective. Adverse outcomes included 2 preterm births, 2 preterm labors, 2 newborns with hepatitis, and one perinatal fetal death. Conclusion: Parturients with ICP who had normal coagulation parameters despite increased liver enzymes preoperatively underwent cesarean delivery under spinal anesthesia without complication. Although maternal outcomes were generally positive, adverse fetal and neonatal outcomes are more likely to occur, particularly in cases with severe ICP.

Keywords: Intrahepatic cholestasis of pregnancy, cesarean delivery, anesthesia outcome, maternal, fetal, neonatal

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