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    Report of the academic work: gestational intrahepatic cholestasis and fetal death
    (Universidad Privada Norbert Wiener, 2017-10-27) Granados Arana, Mariela Tait; Torres Jara, Doris Charito; Ayala Peralta, Félix Dasio
    Objective: To describe the management of an academic case on intrahepatic gestational cholestasis that occurred during maternal health care at Chancay Hospital. Materials and methods: This is an observational, descriptive, retrospective study involving a systematic review of the perinatal medical history of intrahepatic gestational cholestasis managed at Chancay Hospital in March 2014. The study included personal, family, and pathological history, general and specific examination, diagnosis, auxiliary tests, obstetric management, and evolution until discharge. Results: The case presented is of a 21-year-old primigravida at 36 weeks of gestation diagnosed with intrahepatic gestational cholestasis and fetal death. The predominant symptom was generalized pruritus starting at week 32. Hepatic tests showed abnormal results, with an increase in total bilirubin and bile acid levels of 44 micromol/L. The pregnancy was concluded with a vaginal delivery of a stillborn female infant, weighing 3000g, with meconium staining. Postpartum management included ursodeoxycholic acid, with favorable maternal evolution and discharge on the second day postpartum. Conclusion: Intrahepatic gestational cholestasis is a condition in the second half of pregnancy, characterized by pruritus and elevated serum bile acids, leading to intrauterine fetal death.