title: Rifampicin in the treatment of severe intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  To describe the use of combined ursodeoxycholic acid (UDCA) and rifampicin treatment in intrahepatic cholestasis of pregnancy (ICP).
  
  
  METHODS
  A questionnaire survey of 27 women with 28 affected pregnancies identified via the UK and International Obstetric Medicine forum. The clinical case notes of women with ICP treated with combined UDCA and rifampicin therapy were reviewed, and data regarding maternal and perinatal outcomes extracted.
  
  
  RESULTS
  Serum bile acids remained high whilst taking UDCA as monotherapy. In 14 pregnancies (54%) serum bile acids decreased following the introduction of rifampicin. In 10 pregnancies (38%), there was a 50% reduction in serum bile acids. There were no adverse effects reported with either drug.
  
  
  CONCLUSIONS
  This is the first report of the use of rifampicin in ICP. The data suggest that combined treatment with UDCA and rifampicin is an effective way of treating women with severe ICP who do not respond to treatment with UDCA alone.
authors: Women's Health Academic Centre, King's College London, London, United Kingdom.
authors: Victoria
authors: V
authors: Geenes
authors: Women's Health Research Centre, Imperial College London, London, United Kingdom.
authors: Jenny
authors: J
authors: Chambers
authors: Royal Alexandra Hospital, University of Alberta, Edmonton, Canada.
authors: Rshmi
authors: R
authors: Khurana
authors: Department of Women's and Children's Health, Akademiska Hospital, Uppsala University, Uppsala, Sweden.
authors: Elisabeth Wikstrom
authors: EW
authors: Shemer
authors: Royal Alexandra Hospital, University of Alberta, Edmonton, Canada.
authors: Winnie
authors: W
authors: Sia
authors: Liver Unit, University of Birmingham Trust Hospital, Birmingham, United Kingdom.
authors: Dalvinder
authors: D
authors: Mandair
authors: Liver Unit, University of Birmingham Trust Hospital, Birmingham, United Kingdom.
authors: Elwyn
authors: E
authors: Elias
authors: Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Hanns-Ulrich
authors: HU
authors: Marschall
authors: Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
authors: William
authors: W
authors: Hague
authors: Women's Health Academic Centre, King's College London, London, United Kingdom. Electronic address: catherine.williamson@kcl.ac.uk.
authors: Catherine
authors: C
authors: Williamson
mesh_terms: D001647:Bile Acids and Salts / Q000097:blood; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage
chemical_list: D001647:Bile Acids and Salts; D014580:Ursodeoxycholic Acid; D012293:Rifampin
keywords: Bile acids; Obstetric cholestasis; Pregnancy; Rifampicin; Ursodeoxycholic acid