Early induction of labor in high-risk intrahepatic cholestasis of pregnancy: what are the costs?

Archives of Gynecology and Obstetrics
Anne Katrine FribergJens Lyndrup

Abstract

Induction of labor among pregnant women with high levels of total bile acid (TBA) is common among clinicians. We examined, if women with intrahepatic cholestasis of pregnancy (ICP) and TBA ≥ 40 μmol/l have a higher risk of maternal-fetal complications, when labor is induced at 37 weeks of gestation, compared with induction of labor at term in women with low-risk ICP. Retrospective cohort study of 16,185 women delivering at Roskilde University Hospital in the period 2006-2011. Women with high-risk ICP (TBA ≥ 40 μmol/l) had labor induced at 37 weeks of gestation; women with low-risk ICP (TBA < 40 μmol/l) at term. Mode of delivery, duration of induction procedures, highest level of TBA and alanine aminotransferase (ALT) and for the neonates: Apgar scores at 5 min, umbilical cord pHs and SBEs, NICU admissions and birthweights. The incidences of ICP was 1.2 % (95 % CI 1.05-1.39 %) altogether and for high-risk ICP 0.4 % (95 % CI 0.27-0.46 %). No difference was found in mode of delivery, length of induction of labor nor in neonatal outcomes, except for an expected difference in birthweight. In high-risk ICP, ALT was not raised in 10.3 % (95 % CI 2.5-18.2 %). Early induction of labor at 37 weeks of gestation seems justified in high-ris...Continue Reading

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Citations

Jun 22, 2016·Seminars in Immunopathology·Lars BremerGisa Tiegs
Dec 5, 2019·Journal of Neonatal-perinatal Medicine·A L JuuselaM Nazir
Nov 25, 2020·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Cigdem Damla DenizFatma Kubra Sayın
Nov 3, 2020·European Journal of Gastroenterology & Hepatology·Akash RoyRadha Krishna Dhiman

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