PURPOSES: To determine the incidence, obstetrical, and fetal complication rates of intrahepatic cholestasis of pregnancy (ICP) in patients managed expectantly to 40-weeks gestation. METHODS: In a prospective cohort study conducted between February 2008 and January 2010, a total of 21,960 pregnant women in Qassim Region of Saudi Arabia were screened for ICP using specific criteria for diagnosis. The course of pregnancy was monitored to 40-weeks gestation or spontaneous onset of labor, whichever comes first. The measured outcomes were compared with a cross-matched group of healthy pregnant women. Continuous variables were analyzed with t test, while χ(2) test was used for comparing percentages. RESULTS: The incidence of ICP was 0.35% (76/21,960). There was no significant difference between groups in gestational age at delivery, preterm labor, intrauterine fetal death, cesarean section, or respiratory distress syndrome. There was significantly higher intrapartum non-reassuring fetal heart rate patterns and meconium-stained amniotic fluid in ICP group (P < 0.01 and <0.0001, respectively). CONCLUSIONS: The incidence of ICP in this region is low compared to worldwide range. Expectant management to 40-weeks gestation is associated with obstetrical and fetal outcomes comparable to normal pregnancy; however, intrapartum fetal asphyxia is more likely.
PURPOSES: To determine the incidence, obstetrical, and fetal complication rates of intrahepatic cholestasis of pregnancy (ICP) in patients managed expectantly to 40-weeks gestation. METHODS: In a prospective cohort study conducted between February 2008 and January 2010, a total of 21,960 pregnant women in Qassim Region of Saudi Arabia were screened for ICP using specific criteria for diagnosis. The course of pregnancy was monitored to 40-weeks gestation or spontaneous onset of labor, whichever comes first. The measured outcomes were compared with a cross-matched group of healthy pregnant women. Continuous variables were analyzed with t test, while χ(2) test was used for comparing percentages. RESULTS: The incidence of ICP was 0.35% (76/21,960). There was no significant difference between groups in gestational age at delivery, preterm labor, intrauterine fetal death, cesarean section, or respiratory distress syndrome. There was significantly higher intrapartum non-reassuring fetal heart rate patterns and meconium-stained amniotic fluid in ICP group (P < 0.01 and <0.0001, respectively). CONCLUSIONS: The incidence of ICP in this region is low compared to worldwide range. Expectant management to 40-weeks gestation is associated with obstetrical and fetal outcomes comparable to normal pregnancy; however, intrapartum fetal asphyxia is more likely.
Authors: Caroline Ovadia; Paul T Seed; Alexandros Sklavounos; Victoria Geenes; Chiara Di Ilio; Jenny Chambers; Katherine Kohari; Yannick Bacq; Nuray Bozkurt; Romana Brun-Furrer; Laura Bull; Maria C Estiú; Monika Grymowicz; Berrin Gunaydin; William M Hague; Christian Haslinger; Yayi Hu; Tetsuya Kawakita; Ayse G Kebapcilar; Levent Kebapcilar; Jūratė Kondrackienė; Maria P H Koster; Aneta Kowalska-Kańka; Limas Kupčinskas; Richard H Lee; Anna Locatelli; Rocio I R Macias; Hanns-Ulrich Marschall; Martijn A Oudijk; Yael Raz; Eli Rimon; Dan Shan; Yong Shao; Rachel Tribe; Valeria Tripodi; Cigdem Yayla Abide; Ilter Yenidede; Jim G Thornton; Lucy C Chappell; Catherine Williamson Journal: Lancet Date: 2019-02-14 Impact factor: 202.731
Authors: Francesco D'Ambrosi; Matteo Di Maso; Anna Viscardi; Manuela W Ossola; Chiara M Soldavini; Giulia E Cetera; Roberta Erra; Enrico Ferrazzi Journal: J Obstet Gynaecol Res Date: 2022-08-01 Impact factor: 1.697