A patient has a history of previous sudden full term IUFD (unknown cause), now presents with itching at 9th month of pregnancy, with bilirubin of 3 mg/dL, mildly raised AST. A diagnosis of IHCP was made. Management is ?
IHCP is a recurrent condition. The previous IUFD could have been due to IHCP in previous pregnancy. This condition presents mostly in third trimester. IHCP patients must not be allowed to continue pregnancy much beyond 37-38 weeks.
Elective LSCS at 36 weeks
Ursodeoxycholic acid + Induction at 38 weeks with strict intrapaum fetal monitoring
Symptomatic management and terminate at 40+ weeks
FFP transfusion
Medical Illness Complicating Pregnancy