title: Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. A 12-year experience.
abstract: OBJECTIVE
  To assess the efficacy of ursodeoxycholic acid (UDCA) in patients with intrahepatic cholestasis of pregnancy (ICP) and in the outcome of pregnancy.
  
  
  METHODS
  Retrospective analysis of our 12-year experience treating ICP patients with UDCA. Thirty-two patients with pruritus starting before week 34 of pregnancy and with increased serum bile salts (BS) and alanine aminotransferase (ALT) received UDCA (15 mg/kg/day) for at least 3 weeks before delivery. They were compared with 16 historical controls who did not receive UDCA. All patients were followed up until delivery and in puerperium. Newborns were followed up during 3 months.
  
  
  RESULTS
  UDCA treatment attenuated pruritus (P < 0.05), serum bilirubin and ALT decreased (P < 0.05) and BS declined. Delivery at term (> or = 37 weeks) occurred in 65.7% of UDCA-treated patients compared with only 12.5% in controls (P < 0.01). Infants born to mothers treated with UDCA weighed a mean of 500 g more than the controls (2882+/-582 vs 2385+/-582; P < 0.01). At 3 months, all infants developed normally. Twenty-six children whose mothers received UDCA were re-examined after 1-12 years and they and their mothers were healthy.
  
  
  CONCLUSIONS
  UDCA improved pruritus and biochemical cholestasis, and facilitated deliveries at term in ICP patients, with a higher birthweight compared with historical controls. The drug was well tolerated and no adverse effects were detected in their infants.
authors.affiliation: Department of Medicine, University of Chile School of Medicine, Hospital del Salvador, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Zapata
authors.forename: Lorena
authors.initials: L
authors.lastname: Sandoval
authors.forename: Joaquín
authors.initials: J
authors.lastname: Palma
authors.forename: Ismael
authors.initials: I
authors.lastname: Hernández
authors.forename: José
authors.initials: J
authors.lastname: Ribalta
authors.forename: Humberto
authors.initials: H
authors.lastname: Reyes
authors.forename: Manuel
authors.initials: M
authors.lastname: Sedano
authors.forename: Dolores
authors.initials: D
authors.lastname: Tohá
authors.forename: Juan Jorge
authors.initials: JJ
authors.lastname: Silva
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002756:Cholagogues and Choleretics / Q000008:administration & dosage* / Q000009:adverse effects; D002780:Cholestasis, Intrahepatic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007297:Inpatients; D010045:Outpatients; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011537:Pruritus / Q000188:drug therapy; D012189:Retrospective Studies; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase