Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy.
OBJECTIVE
To report our experience in managing intrahepatic cholestasis of pregnancy with ursodeoxycholic acid.


METHODS
All cases of intrahepatic cholestasis of pregnancy that were diagnosed at Bridgeport Hospital from January 1997 to August 1999 were identified. Information was abstracted on demographics, medical and obstetric history, symptoms, laboratory data, therapy and pregnancy outcome. Statistical analysis was primarily descriptive; continuous variables were analyzed with t tests.


RESULTS
A total of 20 cases of intrahepatic cholestasis of pregnancy were identified (0.32% of live births). All patients presented with pruritus. The mean gestational age at onset of symptoms was 31.1 weeks (range 13-38.4, median 32.4). Bile acids were measured in 18 cases and were elevated in all. The mean gestational age at delivery was 36.4 weeks (32.3-39.9). Eight patients were treated with ursodeoxycholic acid (600-1200 mg). All eight patients experienced subjective improvement in pruritus after initiation of treatment with ursodeoxycholic acid. Ursodeoxycholic acid was associated with a decrease in bile acids in most patients (p = 0.16) and with a significant decrease in serum transaminases (p = 0.03).


CONCLUSIONS
Ursodeoxycholic acid is an effective therapy for relief of pruritus and improvement of the liver dysfunction that occurs with intrahepatic cholestasis of pregnancy.
Laifer
S A
SA
Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health, Connecticut 06610, USA. pslaif@bpthosp.org
Stiller
R J
RJ
Siddiqui
D S
DS
Dunston-Boone
G
G
Whetham
J C
JC
D000328:Adult; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008499:Medical Records; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid