|
No wonder Amy is
confused. I have found no data to support the figure of 25% risk of
stillbirth. The latest evidence is the RCOG (U.K) 2006. which is very
informative and exposes a few myths. MM BMJ
2002;324:123-124 ( 19 January ). Editorials . Obstetric
cholestasis: Reid R, Ivey KJ, Rencoret RH, Storey B. Fetal complications
of obstetric cholestasis. BMJ
1976; 1: 870-872[ISI][Medline]. Clinical studies clearly show that when obstetric cholestasis
complicates pregnancies it may lead to premature births in up to
60%, fetal distress in up to 33%, and intrauterine death in up to 2%
of patients.1
The cause of fetal death is acute anoxia.2 he risk of having a stillborn baby is 15% greater for women who have OC
than for other women (Crafter, 2003: 310). Nobody is quite sure why. The baby
may die because of the bile acids, which are known to cross the placenta, or as
a result of being suddenly deprived of oxygen, perhaps because of placental
problems. Crafter,
H. 2003. Problems of Pregnancy. RCOG Jan 2006. Guideline No 43. 6.Obstetricians
should be aware that the stillbirth rate for O.C is comparable to the general
population. The risk of stillbirth in untreated OC is unclear. 9.
obstetricians should be aware that there is insufficient data to support or
refute the popular practice of early induction (37 wks) aimed at reducing late
stillbirth. It is not evidenced based. There
is also no form of fetal monitoring or treatment that can forecast foetal
death. |
