Intrahepatic cholestasis of pregnancy: results of a tertiary referral center

INTRODUCTION: In this study, we aimed to present the pregnancy outcomes of 48 cases followed up in our clinic with the diagnosis of intrahepatic cholestasis of pregnancy. METHODS: Medical records of 48 patients were reviewed retrospectively Diagnostic criteria for ICP: 1-itching 2-laboratory findings supporting ICP (ALT, AST>35U/L, GGT>26U/L, total bilurubin>1.2 mg/dl and serum bile acids>10 µmol/L). All participants were delivered at the 37th week of pregnancy. RESULTS: The mean gestational age at diagnosis was 30.4+-5.4 weeks, and the mean duration from diagnosis to birth was 29.4+-19.5 days. The mean ALT value of the patients was 89.4+-63.5 U/L, the AST value was 103.5+-57.6 U/L, and the serum bile acid value was 37.8+-21.1 µmol/L. Mean birth week was 37.8+-21.1 weeks, and birth weight was 3015+-465 grams. Preterm delivery occurred in 6 (12.5%) cases. These were all spontaneous preterm births. While 45.8% of the cases delivered vaginally, 54.1% of the patients needed a cesarean section. Cesarean section was performed in 5 patients due to fetal distress. Meconium stained amniotic fluid was observed in 11 cases during delivery. Antepartum death did not occur in any of the cases. The mean 1st minute Apgar score of the newborns was 7.5 +- 2.1, the 5th minute Apgar score was 8.1 +- 1.6. was. 7 (14.5%) babies needed NICU. DISCUSSION AND CONCLUSION: ICP carries severe risks for the fetus and newborn. Pregnancy cholestasis should be considered in the diagnosis of pregnant women who present with common itching complaints, close fetal follow-up and early term delivery should be planned in these patients.