Brief Answer:
Delivery should be done by 37-38 weeks

Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Cholestasis of pregnancy or obstetric cholestasis is a condition in which there is abnormal metabolism of bile in liver due to hormonal changes in pregnancy. It is associated with the risk of meconium around fetus and sudden intrauterine death. Moreover, your SGPT and bile acid levels are in very high range, making it a severe obstetric cholestasis.
In such a condition, you should receive ursodeoxycholic acid tablets in a proper dosage to relieve the cholestasis, you should keep a proper count of daily fetal movement, have liver function test repeated weekly, and have biophysical profile by ultrasound weekly to assess the fetal well being.
In obstetric cholestasis, the pregnancy is usually terminated at maximum38 weeks of gestation, if all the other parameters are normal because the chances of Meconium release and sudden intrauterine death increases with increasing gestation. Mode of termination of pregnancy depends upon several conditions like pelvic adequacy for normal delivery, condition of the cervix and status of the fetus.
If pelvis, which is assessed at 37 weeks of gestation, is adequate and cervix is favourable, then you can be safely induced with drugs to attempt a normal delivery. Otherwise a caesarean section has to be resorted to.
A fetus attains its maturity by 37 weeks, so I assure you and suggest you not to worry, and plan your delivery around37-38 weeks of gestation, if you don't get spontaneous labour pains by then.
Mode of delivery will definitely depend upon various conditions, which will be decided by your treating obstetrician.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma

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