PERINATAL OUTCOME IN PREGNANCY COMPLICATED BY OBSTETRIC CHOLESTASIS

Abstract

Objective: To determine the association of adverse perinatal outcome with obstetric cholestasis in females attending a tertiary care hospital

Study Design: Cohort study

Study place and duration: Study was conducted at Obstetrics & Gynecology Department, Combined Military Hospital, Bahawalpur during January to July 2025.

Methodology: Females were examined for obstetric cholestasis and divided in two groups, exposed and unexposed. All the females were then followed-up in OPD until delivery and were assessed for preeclampsia, small for gestational age, preterm delivery, cesarean section, respiratory distress syndrome and postpartum hemorrhage. All information was gathered by Proforma and SPSS version 25” was used for data analysis. Relative risk was calculated to measure the association of obstetric cholestasis with adverse perinatal outcome, with RR>1 as significant risk factor.

Results: The mean age of exposed group was 26.74 ± 3.45 years and unexposed group was 27.04 ± 3.47 years. The mean gestational age at the time of presentation was 33.20 ± 1.65 weeks in exposed females and 32.30 ± 1.97 weeks in unexposed females. Preeclampsia was observed in 6 (12%) vs. 0%, relative risk: 2.136 (95% CI: 1.722, 2.650). Small for gestational age in 24 (48%) vs. 12 (24%), relative risk: 1.641 (95% CI: 1.127, 2.389). Preterm delivery in 37 (74%) vs. 3 (6%), relative risk: 4.269 (95% CI: 2.618, 6.963). Cesarean section in 44 (88%) vs. 26 (52%), relative risk: 3.143 (95% CI: 1.503, 6.574). Respiratory distress syndrome in 41 (82%) vs. 8 (16%), relative risk: 4.741 (95% CI: 2.588, 8.688). Postpartum hemorrhage in 31 (62%) vs. 8 (16%), relative risk: 2.552 (95% CI: 1.701, 3.829).

Conclusion: Through this study findings, we may conclude that there is significant association of adverse perinatal outcomes with obstetric cholestasis