Comparison of Management of Obstetric Cholestasis in our unit with National Guidelines and assess the compliance . 

        Sadia Aziz, Himgauri Sabnis  St Mary Hospital IOW NHS Trust

Introduction

Intrahepatic cholestasis of pregnancy is a multifactorial condition. It is characterised by pruritus in the absence of a primary skin condition, with abnormal maternal bile acid concentrations. The onset of symptoms is most com-mon in the third trimester, but can be earlier in pregnancy. Alternative diagnoses (such as pre-eclampsia) should always be considered before a diagnosis of ICP is made.

Prevalence is influenced by genetic and environmental aspects and varies between populations. In the UK, ICP affects 0.7% of pregnancies in multi-ethnic populations, and1.2%–1.5% of women of Indian-Asian or Pakistani-Asian origin.

Results

Data collected retrospectively in the year April 2023 till March 2024

Total 5 cases of ICP ( 0.5 % ) were recorded  out of 903 deliveries

 4/ 5  (80 %) cases had mild ICP

1/5 (0.5%) had moderate ICP

1/5 (0.5%) had Em lscs

4/5 (80 %) had vaginal deliveries

Action/Recommendation

In our unit 4 patients had BA levels < 40 , however IOL was started less than 40 weeks. Our audit suggests that while management of obstetric cholestasis in our unit is largely aligned with guidelines, there are opportunities for reviewing the SOP , postnatal follow up by checking LFTS ,Bile acid levels , confirming resolution of symptoms..Early identification and documentation of care. Future audits and targeted education of patients and staff could help in optimizing the management of this condition, ensuring better outcomes for both mothers and neonates.