The treatment of intrahepatic cholestasis of pregnancy by dexamethasone
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M L Hirvioja1, R Tuimala, J Vuori
1Department of Obstetrics and Gynecology, University of Tampere, Finland.
Objective:
To investigate whether dexamethasone suppression of fetoplacental oestrogen production can reduce obstetric cholestasis.
Design:
Observational study.
Setting:
Department of Obstetrics and Gynaecology, University of Tampere, Finland.
Subjects:
10 women, at between 28 and 37 weeks gestation, with intrahepatic cholestasis of pregnancy.
Interventions:
Treatment with 12 mg oral dexamethasone daily for 7 days, after which the therapy was gradually discontinued over 3 days.
Main Outcome Measures:
Serum oestriol, oestradiol, total bile acids and ALAT were measured before and during therapy and on days 4 and 7 and ALAT also on day 12. Differences were tested by paired t test.
Results:
Itching disappeared or was relieved in all patients. Serum oestriol level fell significantly by day 1 of treatment, serum oestradiol and total bile acid levels by day 4 and ALAT by day 12 from the beginning of the therapy.
Conclusion:
Dexamethasone is a drug of choice in the treatment of intrahepatic cholestasis of pregnancy.