Objective: This study was to evaluate the grading of intrahepatic cholestasis of pregnancy (ICP).
Methods: All 278 ICP cases were collected in the First Affiliated Hospital of Chongqing Medical University between Jan 1999 and May 2003. They were graded into mild ICP and severe ICP based on liver function test. Outcome of pregnancy and perinatal mortality were assessed.
Results: One hundred and ninety two cases were diagnosed as mild ICP while 86 cases were as severe ICP. There was significant difference in the average time of expectant therapy (10.3 +/- 4.8 vs 19.1 +/- 6.4 days) and gestational weeks (35.8 +/- 1.6 vs 37.7 +/- 1.9) between severe ICP and mild ICP groups (P < 0.01 and P < 0.001). The incidences of meconium passage, newborn asphyxia and admissions to neonatal intensive care unit in severe ICP were significantly higher than that in mild ICP. These were 38.4% vs 9.4%, 12.8% vs 4.2%, and 30.2% vs 9.4%, respectively. The difference of perinatal mortality between the patients with ICP diagnosed by using and not using the grading system (0.7% - 1.2% vs 3.9% - 6.0%) was statistically significant (P < 0.01).
Conclusion: Grading of ICP based on liver function test may improve perinatal prognosis.