*Drs. Zapata and Sandoval contributed equally to this work.
Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy.
A 12-year experience
Version of Record online: 15 DEC 2004
Volume 25, Issue 3, pages 548–554, June 2005
How to Cite
Zapata, R., Sandoval, L., Palma, J., Hernández, I., Ribalta, J., Reyes, H., Sedano, M., Tohá, D. and Silva, J. J. (2005), Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. Liver International, 25: 548–554. doi: 10.1111/j.1478-3231.2004.0996.x
- Issue online: 20 MAY 2005
- Version of Record online: 15 DEC 2004
- Received 22 August 2003, accepted 27 May 2004
- fetal distress;
- pregnancy complications;
- ursodeoxycholic acid
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 (≥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.