Attached
Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic
form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of
research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South
Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric
cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in
the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital
in Colombo Sri Lanka, between 1st January 2011 to 1st january 2014, were recruited for the study.
A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered
questionnaire and patient records were used for data collection. Presentation, characteristics and
pregnancy outcomes were assessed and compared for mothers with ICP against those with pruri-tus in the absence of ICP. Results: The prevalence of ICP in the study population was found to be 27%
(n = 27), Generalized pruritus with pruritus of the palms and soles was identified as the common*
est pattern of pruritus for diagnosed with ICP. Delivery before 37 weeks (p = 0.001), meconium
stained liquor (p = 0.004), placental abruption (p = 0.005). postpartum hemorrhage (p = 0.005),
bleeding manifestation (p = 0.006), preterm labor (p = 0.031) and fetal distress (p = 0.035) were
found to be significantly associated with the presence of ICP. Conclusions: Nearly 1/3 of mothers
presenting with pruritus in pregnancy in Sri Lanka are affected by ICP which is associated with an
increase in a wide range of adverse maternal and fetal outcomes compared to those with pruritus
in the absence of ICP.
