Hormonal contraception after intrahepatic cholestasis of pregnancy

Comparing the use of oral contraception (OC), treatment side effects and the incidence of cholecystolithiasis in women with a history of intrahepatic cholestasis of pregnancy (ICP), before and after introducing ursodeoxycholic acid (UDCA) in the treatment.

Regional epidemiological.

Department of Obstetrics and Gynecology, General Hospital, Trencin, Slovak Republic.

Retrospective analysis of 79 deliveries with ICP between 1992 and 2004. Group 1 included 36 women who delivered between 1992 and 1996 and were not treated by UDCA. Group 2 included 43 women who delivered between 1997 and 2004 and were managed with a 500-750 mg daily dose of UDCA administered orally. In 2008, the questionnaire was sent to all treated women with ICP. The analysis was focused on OC use and presence of cholecystolithiasis, or cholecystectomy in individual groups. The incidence of difficulties comparable to ICP was analyzed in OC users.

The frequency of ICP was the same in both groups (0.4% of deliveries). The questionnaire response rate was 71%. Analysis was conducted in 56 women with ICP--in Groups 1 and 2 it was 26 and 30 women, respectively (the difference statistically insignificant, p=0.81). In the observed population, 15 women (26.8%) used hormonal contraception--in Groups 1 and 2 it was 42.3% and 13.3%, respectively (statistically significant difference, p=0.015). Only one woman in Group 1 reported pruritus during the use of OCs. The frequency of cholecystolithiasis or cholecystectomy occurrence was 26.8% in the entire population--in Groups 1 and 2 it was 38.5% and 16.7%, respectively (statistically significant difference, p=0.043).

Based on our results it is possible to consider the use of OC in women with a history of ICP as safe. Only a minimum of side effects have been recorded in relatively high percentage of OC users.