Emerging Medical Treatments of Intrahepatic Cholestasis of Pregnancy
Sheema Sabahath *
Department of Obstetric and Gynecology, King Abdullah Medical Complex, Jeddah, Saudi Arabia.
Fatmah AlDabbous
College of Medicine, Arabian Gulf University, Manama, Bahrain.
Mansour Mohammed
College of Medicine, King Khalid University, Abha, Saudi Arabia.
Ali Al Alhendi
College of Pharmacy, University of Sunderland, Sunderland, United Kingdom.
Neda Al Yaqoot
College of Medicine, Arabian Gulf University, Manama, Bahrain.
Alya Ali
College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Nora Alfertaj
College of Medicine, Arabian Gulf University, Manama, Bahrain.
Norah Alotaibi
College of Medicine, Gulf Medical University, Ajman, United Arab Emirates.
Areej Alalati
College of Medicine, Arabian Gulf University, Manama, Bahrain.
Haya Alhajri
College of Medicine, Arabian Gulf University, Manama, Bahrain.
Taibah Allahdan
College of Medicine, Arabian Gulf University, Manama, Bahrain.
*Author to whom correspondence should be addressed.
Abstract
Although intrahepatic cholestasis of pregnancy is not a serious one, it can be very distrustful to the affected women. It can also lead to significant complications and adverse events over the fetus as what has been previously reported that it is linked with stillbirth, fetal distress, and premature labor, especially in severely affected cases. Many treatment modalities have been proposed to relieve pruritis and enhance the levels of bile acids within the serum of the affected women. The administration of ursodeoxycholic acid has been studied by various studies in the literature, and evidence is conflicting about its potential efficacy and safety. However, recent evidence for a meta-analysis indicates that the modality can reduce pruritis. Nevertheless, the effect is minimal and not significant when compared to the placebo group. No significant differences were also noticed between the placebo and treatment groups. We also found that other treatment modalities than ursodeoxycholic acid can also be administered. Nonetheless, these were not adequately discussed in the literature, and therefore, should be cautiously administered within the clinical settings. Finally, further trials are needed to validate of the current evidence and enhance the quality of reporting and planning proper management guidelines.
Keywords: Cholestasis, pregnancy, pruritis, treatment, ursodeoxycholic acid