Intrahepatic Cholestasis of Pregnancy: A Single-Center Retrospective Analysis of Obstetric and Neonatal Outcomes

Introduction: Intrahepatic cholestasis of pregnancy (ICP) is an obstetric complication that occurs most frequently in the third trimester and endangers both the mother and fetus. Objective: To analyze the obstetric and neonatal outcomes of patients diagnosed with ICP at our center and compare these findings with current literature, while also reviewing clinical practice guidelines from various scientific societies. Methods: We conducted a retrospective observational descriptive study of all ICP cases at our center from 2013 to 2023. We analyzed maternal baseline characteristics, clinical and laboratory data, as well as maternal and neonatal complications in 273 cases that met the inclusion criteria. Results: Out of 949 initial patients, 273 met the inclusion and exclusion criteria (250 singleton and 23 twin pregnancies) with 94.1% diagnosed in the third trimester. Bile acid levels were not obtained in 41% of cases; 41% were 100 μmol/L, with a mean diagnostic bile acid level of 29.32 μmol/L. The maternal complications included were hypertensive disorders (7.3%), gestational diabetes (8.7%), gestational hypothyroidism (4.7%), and preterm premature rupture of membranes (2.2%). Labor was medically induced in 77.3% of cases, while 22.7% started spontaneously. Vaginal delivery occurred in 64.1%, and cesarean section in 34.8%, all following institutional protocols. Neonatal complications included 20.5% preterm births and 9 NICU admissions, none due to ICP-related causes. Conclusions: These findings highlight the need for standardized care protocols and prospective studies to ensure early diagnosis and appropriate management to improve maternal and fetal outcomes.