39-year-old woman with a liver condition and previous Caesarean section safely delivers a healthy baby boy following premature rupture of membranes

National, 11th September 2026: 39-year-old woman with a high-risk pregnancy was successfully managed at Cocoon Hospital, Chandigarh, after she developed sudden fluid leakage at 37 weeks of pregnancy. She subsequently developed three episodes of redness, itching and hive-like skin rashes, which led doctors to identify intrahepatic cholestasis of pregnancy (IHCP), a liver-related condition that can occur during pregnancy.

The patient had previously undergone a lower-segment Caesarean section approximately eight years earlier and had been under regular medical supervision during her current pregnancy. Given her obstetric history and clinical condition, the medical team had planned a repeat Caesarean delivery.

At 37 weeks of pregnancy, the patient experienced fluid leakage, indicating that her membranes had ruptured. Given her history of a previous Caesarean section, existing liver condition and the decision not to attempt a trial of labour after Caesarean (TOLAC), the medical team promptly reassessed her and proceeded with an emergency repeat Caesarean section in the interest of maternal and foetal safety.

The surgical team encountered adhesions involving the omentum and lower uterine segment, which were carefully managed through adhesiolysis. A healthy male baby weighing 2.8 kg was delivered in vertex presentation and was handed over to the paediatric team for routine neonatal care. The procedure was completed successfully, with no major intraoperative complications or documented postpartum haemorrhage.

After delivery, the mother developed recurrent redness, itching and hive-like skin lesions. She was evaluated for a possible allergic reaction, including a review of recent medications and potential triggers. Antihistamines and corticosteroids were started, and further allergy evaluation was advised to identify the possible cause and guide future precautions.

Dr Priyanka Sharma, Senior Consultant – Obstetrics and Gynaecology, Cocoon Hospital, Chandigarh, said, “High-risk pregnancies need careful monitoring, particularly when there are multiple factors involved. In this case, the patient’s IHCP, previous Caesarean section and premature rupture of membranes meant that we had to reassess the situation and decide on the safest course of delivery. Our priority was to ensure the wellbeing of both the mother and baby, with the collaborative efforts of obstetric, anaesthetic and neonatal teams. We also continued to monitor the mother after delivery when she developed skin reactions, and appropriate treatment was given until she was stable.”

Following treatment and close monitoring, the patient remained stable and was discharged on the third day after surgery with the necessary medication and follow-up advice. She was also advised to undergo further allergy evaluation and to report any recurrence of the symptoms.

Commenting on the case, Dr Dilshad Khan, Cluster Head, Cocoon Hospital, Chandigarh, said, “In high-risk pregnancies, the situation can change quickly and decisions often need to be taken based on the patient’s condition at that time. In this case, the onset of premature rupture of membranes meant that we had to reassess the delivery plan promptly, keeping her previous Caesarean section and IHCP in mind. At Cocoon Hospitals, we are equipped to handle such complex and evolving clinical situations, with the right expertise, advanced facilities and clinical preparedness to make timely decisions when every moment matters. Our focus is to ensure that women with high-risk pregnancies have access to the specialised care they need, supported by a team that is prepared to manage complexities at every stage.”

The case demonstrates the importance of recognising changes in a high-risk pregnancy early and taking appropriate clinical decisions when required. Close coordination between the obstetric, anaesthetic, neonatal and nursing teams was an important part of the patient’s care.

Cocoon Hospital, Chandigarh, provides maternity and obstetric care, including management of high-risk pregnancies, foetal monitoring, and neonatal support, with care focused on the needs of both mother and baby.