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Obstet Gynecol. 2009 Feb;113(2 Pt 2):528-31. doi: 10.1097/AOG.0b013e31818db1c9.

Sudden fetal death in intrahepatic cholestasis of pregnancy.

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  • 1University of Southern California, Los Angeles, California, USA. richarhl@usc.edu



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


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.


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

[PubMed - indexed for MEDLINE]
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