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introduction IHCP is a liver disorder that occurs typically in 2nd and 3rd trimester, marked by pruritis, elevated bile acids and a higher risk of fetal complications including preterm birth, fetal distress and stillbirth.The overall prevalence of IHCP us 1.2-1.5%. recent studies have raised concerns about the potential link between progesterone use and the incidence if IHCP. ? aim and objective ? aim of the study is to asses the maternal and perinatal outcomes in pregnant women diagnosed with IHCP with emphasis on incidence of IHCP in those receiving progesterone supplementation. ? material and methods ? A ?retrospective cohort study was conducted at ankura hospitals 9M gachibowli , hyderabad involving 50 pregnancy women diagnosed with IHCP in the year 2023-2024.Diagnosis ?was based in clinical symptoms (pruritis) , LFT and elevated bile acids patients were divided into 2groups- those who received? progesterone supplementation and those who did not study assessed the? maternal and perinatal outcomes such as preterm birth, c- section rate, fetal distress, still birth, birth weight, NICU admissions statistical analysis were performed to evaluate significant differences between the two groups ? ?results ?the incidence of IHCP was higher in pregnant women with progesterone supplementation when compared to non supplemented group the adverse perinatal outcome were higher in patients with IHCP ? conclusion ? this study highlights the increased incidence of intrahepatic cholestasis of pregnancy associated with progesterone supplementation, which may adversely affect both maternal and fetal outcomes. Elevated progesterone levels can impair bile acid transport in the liver, contributing to cholestasis. Maternal outcomes include a higher risk preterm labor and postpartum hemorrahage, while fetal outcomes may involve an increased risk of meconium staining, preterm birth, and adverse neonatal outcomes. These findings underscore the importance of careful monitoring and management of progesterone supplementation in pregnant women, particularly those at higher risk for IHCP, to improve both maternal and fetal health.