| Popis: |
Context: The present study aims at the correlation of symptoms of Intrahepatic Cholestasis of Pregnancy(ICP) and subsidence of disease process by administration of Ursodeoxycholic acid and its outcome with the pregnant mother and newborn baby. There is a rising trend of cholestasis in pregnancy in the present era & especially affecting in the last trimester of pregnancy when hormonal influences are at the peak. Aims: To find out the frequency of Intrahepatic Cholestasis of pregnancy (ICP) among the pregnant woman attending at Central Referral Hospital. To analyse the clinical profile of the patients attending CRH having intrahepatic cholestasis of the pregnancy(ICP). To study the immediate maternal and fetal outcome of ICP patient Settings and Designs: A Progressive observational study conducted between January 2019 to December 2019 at Department of Obstetrics & Gynaecology,Central Referral Hospital (CRH), Tadong, Gangtok, Sikkim. Materials and Methods: 60 pregnant women with gestational age between 24 weeks to 42 weeks diagnosed as ICP were included. Results: Theincidence of ICP is 60 (2.50 %) over a study period of one year. Majority diagnosed in the age group between 26-30 years, mostly were primigravida. Out of 27 multigravida ICP pregnancies, only 7 mothers (25%) had past history of ICP. ICP most commonly occurred (95%) in 32-36 weeks of gestation.35 pts (58.33%) had symptomatic response to UDCA, 25 pts (41.67%) did not have response. After 6 weeks of UDCA t/t, Bilirubin further came down to 0.67, median value 0.7 and std dev. 0.16, statistically significant. 5% (3 mothers) with IHCP had deranged coagulation profile along with increased level of AST, ALT and normalisation of LFT within 6 weeks of termination of pregnancy. Statistical analysis was done by using descriptive and inferential statistics using Chi square test and Student’s paired t test and software used in the analysis were SPSS 24.0 version and Graph Pad Prism 7.0 version and p Conclusion: The incidence of ICP is 2.51% in our hospital, which is a Referral Centre in Sikkim. The Intrahepatic Cholestasis in Pregnancy has an adverse effect on the maternal health and fetal outcome, and hence, early diagnosis with careful clinical examination and biochemical assessment and follow-up are essential. UDCA provides symptomatic relief, improvement of Liver Functions and contribute to improvement of perinatal outcome. The obstetrics intervention rate is high in our study, so a protocol is made for active management of labour after 37 completed weeks to improve perinatal outcome. |
