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Related Experiment Videos

Interventions for treating cholestasis in pregnancy.

R F Burrows1, O Clavisi, E Burrows

  • 1Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia, 3168. robert.burrows@med.monash.edu.au

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary

Limited evidence supports treatments for cholestasis of pregnancy (CIP). Studies on S-adenosylmethionine (SAMe) and ursodeoxycholic acid (UDCA) showed inconsistent results for symptom relief and biochemical markers.

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Area of Science:

  • Obstetrics and Gynecology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Cholestasis of pregnancy (CIP) is associated with adverse maternal and fetal outcomes.
  • The exact pathophysiology of CIP remains unclear, leading to empiric treatment strategies.

Purpose of the Study:

  • To evaluate the effectiveness and safety of various therapeutic interventions for intrahepatic cholestasis of pregnancy (CIP).

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) comparing interventions to placebo or alternative treatments.
  • Searched multiple databases up to March 2001; excluded trials published only as abstracts.
  • Assessed trial eligibility and quality, contacting authors for missing data.

Main Results:

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  • Nine RCTs (227 women) were included; data reporting was inconsistent.
  • S-adenosylmethionine (SAMe) showed limited benefit in one trial.
  • Ursodeoxycholic acid (UDCA) did not consistently relieve pruritus but reduced bile acids/liver enzymes in one study; fewer preterm births were noted.
  • Guar gum and activated charcoal showed no significant benefits.
  • Combined UDCA + SAMe showed some improvements but evidence remains limited.

Conclusions:

  • Insufficient evidence exists to recommend guar gum, activated charcoal, SAMe, or UDCA for treating CIP.
  • Inconsistent and inadequate reporting in small studies prevented robust conclusions.