Publication:

Prevalence of gestational diabetes mellitus in intrahepatic cholestasis of pregnancy

Background Incidence of IHCP in Indian population is 0.02%-2.4% and that of GDM is 3.8%-17.9%. Frequent co-existence of both has raised the question of any association. There exists only few studies to prove or disprove any association. Objective of current study was to determine the prevalence of GDM in women with IHCP and to compare the feto-maternal outcome in women with GDM with or without IHCP.

Methods The study was conducted in the Department of Obstetrics and Gynaecology, VMMC and SJH, New Delhi. Women with singleton pregnancy ≥28wks were recruited for the study and further categorized as women with IHCP and women without IHCP according to their diagnosis of IHCP by the RCOG guidelines. OGTT with 75g glucose was done to make the diagnosis of GDM. Management was as per obstetrics protocol and feto-maternal outcomes recorded till delivery.

Results No statistically significant difference in the prevalence of GDM observed in both groups (5.4% in women with IHCP and 8.2% in women without IHCP, p=0.220). Significantly higher number of preterm deliveries (21%, p<0.001), induced labour (53.6%, p<0.001), women undergoing LSCS (46.3%, p<0.001) in women with IHCP. No association of FGR, MSL, Fetal maturity, labour onset, mode of delivery, stillbirth, low APGAR score, NICU admission, or PPH in women with GDM with or without IHCP.

Conclusions The prevalence of GDM is not higher in women with IHCP but significantly higher incidence of preterm delivery, induced labour, and Caesarean sections in women with IHCP. No significant difference in feto-maternal outcome in women with GDM with or without IHCP.