Comprehensive analysis of jaundice in pregnancy: Evaluating maternal and fetal outcomes – A 3-year retrospective study in a tertiary care center

Abstract

Background: Jaundice during pregnancy poses significant risks to both maternal and fetal health. This retrospective study aimed to assess the incidence, causes, and outcomes of jaundice among pregnant women admitted to a tertiary care center over a 3-year period. Aims and Objectives: The primary objectives were to identify the incidence of jaundice, analyze its causes, and evaluate the maternal and fetal outcomes in cases of jaundice during pregnancy. Materials and Methods: Conducted as a case series with clinical correlation, the study spanned 3 years (2021–2023) at the Department of Obstetrics and Gynecology, Kempegowda Institute of Medical Science, Bangalore. Data from parturition books and case sheets were collected after institutional ethical committee approval. Investigations included a complete blood count, liver function tests, coagulation profile, and serology. Fetal and maternal outcomes were recorded. Results: Out of 9 cases, 7 were diagnosed with intrahepatic cholestasis of pregnancy (IHCP), while 1 case each involved hemolysis, elevated liver enzymes, low platelet syndrome, and unconjugated hyperbilirubinemia specific to pregnancy. IHCP is correlated with adverse perinatal outcomes, including meconium-stained amniotic fluid and fetal distress. Cesarean sections were prevalent (58%), often indicated by previous lower segment cesarean sections and non-progression of labor. Conclusion: The study underscores the substantial association between IHCP and adverse perinatal outcomes, emphasizing the heightened prevalence of cesarean sections in pregnancies complicated by jaundice. It highlights the necessity for vigilant monitoring and tailored management strategies to mitigate risks and ensure favorable maternal and fetal outcomes in cases of jaundice during pregnancy.