INTRAHEPATIC CHOLESTASIS OF PREGNANCY: A STUDY TO IDENTIFY THE CONTRIBUTING FACTORS AND FETOMATERNAL OUTCOME

Resumen

Objective: To determine the contributing factors and evaluate the fetomaternal outcomes in patients with intrahepatic cholestasis of pregnancy. Study Design: Descriptive case series. Place and Duration of Study: Department of Obstetrics & Gynecology, University of Lahore Teaching Hospital, Lahore, in collaboration with Social Security Hospital, Multan Road, Lahore, from October 2025 to February 2026. Methodology: A total of 105 pregnant women diagnosed with intrahepatic cholestasis of pregnancy were included using non-probability consecutive sampling. Women aged 18–45 years, parity <5, and gestational age >24 weeks were enrolled. Patients with other causes of cholestasis were excluded. Data regarding demographic variables, clinical features, and contributing factors including gestational diabetes, hypertension, hyperlipidemia, multiple pregnancy, previous and family history of ICP were recorded. Fetomaternal outcomes including preterm delivery, cesarean section, postpartum hemorrhage, poor Apgar score, low birth weight, and intrauterine fetal death were assessed. Data were analyzed using SPSS version 25.  Results: The mean age of patients was 30.8 ± 7.2 years, and the mean gestational age was 32.4 ± 4.1 weeks. Common contributing factors included hyperlipidemia (44.8%), gestational diabetes (39.0%), hypertension (34.3%), and previous history of ICP (30.5%). Preterm delivery was observed in 43.8% of cases, cesarean section in 49.5%, low birth weight in 36.2%, poor Apgar score in 32.4%, postpartum hemorrhage in 20.0%, and intrauterine fetal death in 10.5%. Significant associations were found between preterm delivery and gestational diabetes, hypertension, hyperlipidemia, multiple pregnancy, and previous history of ICP (p ≤0.05). Conclusion: Intrahepatic cholestasis of pregnancy is associated with multiple metabolic and obstetric risk factors and leads to significant adverse fetomaternal outcomes.