A Retrospective Observational Study of Intrahepatic Cholestasis of Pregnancy and Its Fetomaternal Outcomes at a...

Pruritus in pregnancy may be the earliest clinical indicator of intrahepatic cholestasis of pregnancy (ICP), a disorder associated with adverse fetal and maternal outcomes.

The aim of the study was to assess ICP among pregnant women presenting with pruritus in a tertiary care center and evaluate its fetomaternal impact.

This retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care center from November 2024 to April 2025. A total of 160 pregnant women with pruritus were evaluated using antenatal records, laboratory reports, delivery registers, and NICU data. ICP was diagnosed based on pruritus with serum bile acid levels ≥10 µmol/L and/or liver function tests suggestive of cholestasis, after excluding other hepatic disorders.

Among 160 women, 24 were diagnosed with ICP. ICP was significantly associated with multigravida status, later onset of itching, generalized pruritus, palms and soles involvement, and nocturnal aggravation. Serum bile acids, alanine aminotransferase, and aspartate transaminase were markedly higher in ICP women. Meconium-stained liquor, fetal growth restriction, preterm delivery, and induction of labor were significantly increased in the ICP group. Low birth weight, poor Apgar score, NICU admission, respiratory distress, and neonatal jaundice were also proportionately higher.

ICP in pruritic pregnant women was associated with characteristic clinical features, biochemical derangement, and increased adverse fetomaternal outcomes.