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Case Reports
. 2009 Feb;113(2 Pt 2):528-531.
doi: 10.1097/AOG.0b013e31818db1c9.

Sudden fetal death in intrahepatic cholestasis of pregnancy

Richard H Lee  1 , Marc H Incerpi, David A Miller, Bhuvan Pathak, T Murphy Goodwin
Affiliations
Case Reports

Sudden fetal death in intrahepatic cholestasis of pregnancy

Richard H Lee et al. Obstet Gynecol. 2009 Feb.

Abstract

Background: Intrahepatic cholestasis of pregnancy is associated with an increased risk of fetal death. The mechanism of death is unknown.

Cases: The first case involved a young primipara with pruritus and a bile acid concentration of 79 mumol/dL. While undergoing fetal heart rate monitoring, the fetus had a prolonged deceleration resulting in intrauterine death. The second case involved a young multipara with cholestasis who received ursodeoxycholic acid. Her bile acid concentration improved to13 micromol/dL. At 34 weeks of gestation, she had uterine contractions with prolonged decelerations resulting in delivery of her fetus with Apgar scores of 0, 0, and 5 at 1, 5, and 10 minutes, respectively.

Conclusion: Fetal death from intrahepatic cholestasis of pregnancy can be abrupt and not reliably predicted by the characteristics of the fetal heart rate tracing.

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