Intervention Review

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Interventions for treating cholestasis in pregnancy

  1. Vinita Gurung1,
  2. Michael Stokes2,
  3. Philippa Middleton3,
  4. Stephen J Milan4,
  5. William Hague5,
  6. Jim G Thornton1,*

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 24 JUN 2013

Assessed as up-to-date: 1 MAR 2013

DOI: 10.1002/14651858.CD000493.pub2


How to Cite

Gurung V, Stokes M, Middleton P, Milan SJ, Hague W, Thornton JG. Interventions for treating cholestasis in pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD000493. DOI: 10.1002/14651858.CD000493.pub2.

Author Information

  1. 1

    University of Nottingham, Department of Obstetrics and Gynaecology, Nottingham, Nottinghamshire, UK

  2. 2

    The University of Adelaide, Discipline of Obstetrics and Gynaecology, North Adelaide, SA, Australia

  3. 3

    The University of Adelaide, ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Institute, Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia

  4. 4

    St George's, University of London, Population Health Sciences and Education, London, UK

  5. 5

    Women's and Children's Hospital, Adelaide, South Australia, Australia

*Jim G Thornton, Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham, Nottinghamshire, NG5 1PB, UK. jim.thornton@nottingham.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 24 JUN 2013

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Binder 2006 {published data only}
  • Binder T, Salaj P, Zima T, Vitek L. Randomized prospective comparative study of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of intrahepatic cholestasis of pregnancy. Journal of Perinatal Medicine 2006;34:383-91.
  • Binder T, Salaj P, Zina T, Vitek L. [Ursodeoxycholic acid, S-adenosyl-L-methionine and their combinations in the treatment of gestational intrahepatic cholestasis (ICP)]. Ceska Gynekologie 2006;71(2):92-8.
Diaferia 1996 {published data only}
  • Diaferia A, Nicastri PL, Tartagni M, Loizzi P, Iacovizzi C, Di Leo A. Ursodeoxycholic acid therapy in pregnant women with cholestasis. International Journal of Gynecology and Obstetrics 1996;52(2):133-40.
Fang 2009 {published data only}
  • Fang J, Gou WL, Li QL. [Effect of integrative Chinese and Western medicine in treating pregnant women with intrahepatic cholestasis]. [Chinese]. [Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongguo Zhongxiyi Jiehe Zazhi/Chinese] Journal of Integrated Traditional and Western Medicine [Zhongguo Zhong Xi Yi Jie He Xue Hui, Zhongguo Zhong Yi Yan Jiu Yuan Zhu Ban] 2009;29(10):869-71.
Floreani 1996 {published data only}
  • Floreani A, Paternoster D, Melis A, Grella PV. S-adenosylmethionine versus ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy: preliminary results of a controlled trial. European Journal of Obstetrics & Gynecology 1996;67:109-3.
  • Floreani A, Paternoster D, Melis A, Zappala F, Chiaramonte M, Grella PV. A controlled trial with S-adenosylmethionine versus ursodeoxycholic acid in intrahepatic cholestasis of pregnancy [EASL abstract]. Journal of Hepatology 1996;25 Suppl 1:S136.
Frezza 1984 {published data only}
Frezza 1990 {published data only}
  • Frezza M, Cammareri G, di Padova C, Italian Study Group for ICP. Beneficial effects of S-adenosylmethionine in pregnant women with cholestasis: results of a multicenter controlled trial (abstract). Journal of Hepatology 1987;5(Suppl 1):S27.
  • Frezza M, Centini G, Cammareri G, Le Grazie C, Di Padova C. S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepato-Gastroenterology 1990;37(Suppl 2):122-5.
Glantz 2005 {published data only}
Huang 2004 {published data only}
  • Huang JY, Liu H. Analysis on therapeutic effect of Western and Chinese drug in treating intrahepatic cholestasis pregnancy. Chinese Journal of Integrated Traditional & Western Medicine 2004;24(4):309-11.
Kaaja 1994 {published data only}
  • Kaaja RJ, Kontula KK, Raiha A, Laatikainen T. Treatment of cholestasis of pregnancy with peroral activated charcoal. A preliminary study. Scandinavian Journal of Gastroenterology 1994;29(2):178-81.
Kondrackiene 2005 {published data only}
  • Kondrackiene J, Beuers U, Kupcinskas L. Efficacy and safety of ursodeoxycholic acid versus cholestyramine in intrahepatic cholestasis of pregnancy. Gastroenterology 2005;129:894-901.
  • Kondrackiene J, Kupcinskas L, Sumskiene J. Efficacy of moderate doses of ursodeoxycholic acid in comparison to cholestyramine in the treatment of intrahepatic cholestasis of pregnancy [abstract]. Journal of Hepatology 2001;34(1):186.
Leino 1998 {published data only}
  • Leino R, Ekblad U, Irjala K, Erkkola R. Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. Prenatal and Neonatal Medicine 1998;3 Suppl 1:67.
Liu 2006 {published data only}
  • Liu Y, Qiao F, Liu H, Liu D. Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. Journal of Huazhong University of Science and Technology. Medical Sciences 2006;26(3):350-2.
Luo 2008 {published data only}
  • Luo DH. Clinical observation on the effect on of Transmetil combined with ursodeoxycholic acid for intrahepatic cholestasis of pregnancy. Modern Journal of Integrated Traditional Chinese and Western Medicine [Xian Dai Zhong Xi Yi Jie He Za Zhi] 2008;17(7):1011-2.
Nicastri 1998 {published data only}
Palma 1997 {published data only}
  • Meng LJ, Reyes H, Axelson M, Palma J, Hernandez I, Ribalta J, et al. Progesterone metabolites and bile acids in serum of patients with intrahepatic cholestasis of pregnancy: effect of ursodeoxycholic acid therapy. Hepatology 1997;26(6):1573-9.
  • Palma J, Reyes H, Ribalta J, Hernandez I, Sandoval L, Alumna R, et al. Ursodeoxycholic acid in the treatment of cholestasis of pregnancy: a randomized, double-blind study controlled with placebo. Journal of Hepatology 1997;27(6):1022-8.
  • Palma J, Reyes H, Ribalta J, Hernandez I, Sandoval L, Silva O, et al. Ursodeoxycholic acid in cholestasis of pregnancy: final report of a randomized, double-blind, placebo controlled study. Hepatology 1996;24(4 Pt 2):373A.
PITCH 2012 {published data only}
  • Chappell LC, Gurung V, Chambers J, Seed PT, Williamson C, Thornton JG. PITCH: Two randomised controlled trials in obstetric cholestasis: Ursodeoxycholic acid versus placebo and early delivery versus expectant management. Archives of Disease in Childhood: Fetal and Neonatal Edition 2011;96:Fa110-Fa111.
  • Chappell LC, Gurung V, Seed PT, Chambers J, Williamson C, Thornton JG. Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial. BMJ 2012;344:e3799.
  • Gurung V, Chappell L, Seed P, Chambers J, Williamson C, Thornton J. Pitch: Ursodeoxycholic acid versus placebo, and early delivery versus expectant management in the management of intrahepatic cholestasis of pregnancy: Two randomised controlled trials. International Journal of Gynecology and Obstetrics 2012;119(Suppl 3):S363-4.
  • Gurung V, Williamson C, Chappell L, Chambers J, Briley A, Broughton Pipkin F, et al. Pilot study for a trial of ursodeoxycholic acid and/or early delivery for obstetric cholestasis. BMC Pregnancy and Childbirth 2009;9:19.
  • Nelson-Piercy C. Obstetric cholestasis. BJOG: an international journal of obstetrics and gynaecology 2008;115(s1):20.
  • Thornton G, Gurung V, Chappel C, Williamson C, Chambers J. Ursodeoxycholic acid versus placebo, and early delivery versus expectant management, in women with obstetric cholestasis: Two semi-factorial randomised clinical trials. Journal of Maternal-Fetal and Neonatal Medicine 2012;25(S2):100-1.
  • Williamson C, Chappell LC, Gurung V, Chambers J, Seed PT, Thornton JG. Pitch: Two randomised controlled trials in intrahepatic cholestasis of pregnancy: Ursodeoxycholic acid vs. placebo and early delivery vs. expectant management. Hepatology 2011;54(4 Suppl):925A.
Ribalta 1991 {published data only}
  • Ribalta J, Reyes H, Gonzalez MC, Iglesias J, Arrese M, Poniachik J, et al. S-adenosyl-L-methionine in the treatment of patients with intrahepatic cholestasis of pregnancy: a randomized, double-blind, placebo-controlled study with negative results. Hepatology 1991;13(6):1084-9.
Riikonen 2000 {published data only}
  • Gylling H, Riikonen S, Nikkila K, Savonius H, Miettinen TA. Oral guar gum treatment of intrahepatic cholestasis and pruritus in pregnant women: effects on serum cholesterol and other non-cholesterol sterols. European Journal of Clinical Investigation 1998;28(5):359-63.
  • Riikonen S, Savonius H, Gylling H, Nikkila K, Tuomi AM, Miettinen TA. Oral guar gum, a gel-forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy. Acta Obstetricia et Gynecologica Scandinavia 2000;79(4):260-4.
Roncaglia 2004 {published data only}
  • Roncaglia N, Arreghini A, Locatelli A, Bellini P, Andreotti C, Ghidini A. Obstetric cholestasis: outcome with active management. European Journal of Obstetrics and Gynaecology and Reproductive Biology 2002;100(2):167-70.
  • Roncaglia N, Locatelli A, Arreghini A, Assi F, Cameroni I, Pezzullo JC, et al. A randomised controlled trial of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of gestational cholestasis. BJOG: an International Journal of Obstetrics and Gynaecology 2004;111:17-21.
  • Roncaglia N, Locatelli A, Bellini P, Arreghini A, Andreotti C, Ghidini A. A randomised controlled trial of ursodeoxycholic acid and S-adenosyl-l-methionine in the treatment of gestational cholestasis [abstract]. American Journal of Obstetrics and Gynecology 2000;182(1 pt 2):S167.
Shi 2002 {published data only}
  • Shi DY, Chen H, Xiao M. Observation on the effect of danxiaoling in supplementary treatment of intrahepatic cholestasis in pregnancy. Zhongguo Zhong Xi Yi Jie He Za Zhi 2002;22(2):116-8.
Zhang 2012 {published data only}
  • Zhang L, Qi HB, Li Z, Fu XD, Chen L. Multicenter randomized prospective controlled study of ursodeoxycholic acid and s-adenosyl-l-methionine in the treatment of intrahepatic cholestasis of pregnancy. International Journal of Gynecology and Obstetrics 2012;119(Suppl 3):S526.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Elias 2001 {published data only}
  • Elias E. A double blind, randomized placebo controlled trial (DBRCT) or ursodeoxycholic acid in obstetric cholestasis (OC). National Research Register (www.controlled-trials.com) (accessed 21 November 2001).
Shi 2006 {published data only}
  • Shi DY, Chen H, Tian XY. Clinical and experimental study on wuling pill in treating gestation period intrahepatic cholestasis. Chinese Journal of Integrated Traditional and Western Medicine 2006;26(2):114-8.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Wang 2003 {published data only}
  • Wang DZ, Chen J. Study of ursodeoxycholic acid in 64 patients with intrahepatic cholestasis of pregnancy. Journal of Practical Medical Techniques 2003;10(9):991-2.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Mazzella 2010 {published data only}
  • Mazzella G, Azzaroli F. Ursodeoxycholic acid and cholestasis of pregnancy. ClinicalTrials.gov accessed 6 June 2011.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Alsulyman 1996
  • Alsulyman OM, Ouzounian JG, Ames-Castro M, Goodwin TM. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management. American Journal of Obstetrics and Gynecology 1996;175:957-60. [MEDLINE: 8885754]
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Bacq 1997
Berg 1986
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Bernhard 1994
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Beuers 2001
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Beuers 2006
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Milkiewicz 2002
Mitsuyoshi 1999
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Paternoster 2002
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  • Roncaglia N, Arreghini A, Locatelli A, Bellini P, Andreotti C, Ghidini A. Obstetric cholestasis: outcome with active management. European Journal of Obstetrics and Gynaecology and Reproductive Biology 2002;100(2):167-70.
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References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Burrows 2001
  • Burrows RF, Clavisi O, Burrows E. Interventions for treating cholestasis in pregnancy. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD000493]