Vol. 2, Issue 1, Part A (2018)

Background: Intrahepatic cholestasis of pregnancy (ICP) is a gestation-specific hepatobiliary disorder, predominantly manifesting in the third trimester, characterized by elevated serum bile acids and liver dysfunction. Although self-limiting postpartum, ICP poses substantial risks to fetal well-being.

Objectives: To evaluate hepatic enzyme derangements in women diagnosed with ICP and to correlate these biochemical findings with maternal and neonatal outcomes.

Materials and Methods: This cross-sectional, observational study was conducted over a 12-month period at the Department of Obstetrics and Gynaecology, Madha Medical College and Hospital, Chennai. A total of 50 pregnant women with a confirmed diagnosis of ICP were enrolled. Liver function parameters—including ALT, AST, ALP, GGT, and bilirubin—along with serum bile acids were analyzed. Maternal outcomes (labor induction, preterm birth, delivery mode) and neonatal endpoints (birth weight, NICU admission, stillbirth) were systematically recorded.

Results: The mean age of participants was 27.6 years. Notable elevations in ALT (92.4 IU/L) and AST (88.7 IU/L) were observed. ALP and GGT levels were raised in a subset of patients. Bile acid concentrations exceeded 40 µmol/L in 30% of cases. Maternal complications included preterm labor (16%), meconium-stained amniotic fluid (20%), and cesarean delivery (36%). Neonatal complications comprised low birth weight (18%), NICU admission (14%), and one instance of stillbirth (2%).

Conclusion: Serum transaminase elevation, particularly ALT and AST, is a consistent feature of ICP and may serve as a supplementary diagnostic marker alongside bile acid profiling. Early identification and intervention remain critical to improving perinatal outcomes in affected pregnancies.