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Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy.
Author(s) -
Zapata Rodrigo,
Sandoval Lorena,
Palma Joaquìn,
Hernández Ismael,
Ribalta José,
Reyes Humberto,
Sedano Manuel,
Tohá Dolores,
Silva Juan Jorge
Publication year - 2005
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2004.0996.x
Subject(s) - ursodeoxycholic acid , cholestasis of pregnancy , medicine , cholestasis , pregnancy , bile acid , gastroenterology , adverse effect , gestation , bilirubin , fetus , biology , genetics
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 (≥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.