International Journal of Clinical Obstetrics and Gynaecology

Author(s): Suraj Ashokrao Mokade, Sarita Rajbhar, Kirti Sinha, Pushpawati Thakur and Sarita Agrawal

Abstract: First-trimester cholestasis of pregnancy must be aggressively evaluated, as it may indicate an underlying liver disorder as rare as autoimmune hepatitis. Autoimmune hepatitis (AIH) is a rare chronic liver disorder that disproportionately affects women of childbearing age. Pregnancy in patients with AIH poses unique clinical challenges, especially when coexisting with intrahepatic Cholestasis of Pregnancy (ICP), another hepatobiliary disorder associated with significant fetal risk. AIH in pregnancy has historically been linked to increased rates of maternal hepatic flares, fetal growth restriction, and preterm labour, whereas ICP is associated with adverse perinatal outcomes, including stillbirth. We report a case of a 30-year-old multiparous woman with a history of chronic uveitis and adverse pregnancy outcomes who presented with jaundice at 13 weeks of gestation. Workup revealed positive autoimmune markers, and a liver biopsy confirmed chronic hepatitis. Despite immunosuppressive therapy and close surveillance, preterm labour ensued at 28+5 weeks, necessitating emergency Lower Segment Caesarean Section (LSCS). The postpartum course was favorable, with normalization of liver function. This report underscores the importance of early diagnosis, interdisciplinary management, and vigilant fetomaternal monitoring in optimizing outcomes.

DOI: https://doi.org/10.33545/gynae.2025.v9.i5d.1715

Pages: 248-251 | 140 Views | 47 Downloads

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