The Pharmacological Management of Intrahepatic Cholestasis of Pregnancy

Francesco      Azzaroli; Laura      Turco; Andrea      Lisotti; Claudio      Calvanese; Giuseppe      Mazzella

Abstract

Intrahepatic cholestasis of pregnancy is the most common liver disease occurring in the second half of pregnancy, characterized by pruritus and elevated serum bile acids often coupled to abnormal liver tests. Maternal prognosis is favourable with a complete symptom resolution after delivery, while preterm deliveries, fetal respiratory distress and stillbirths may occur. The goal of the pharmacological treatment of the disease is to improve maternal symptoms and biochemical alterations and, most importantly, to reduce fetal adverse events. The present manuscript will review the current knowledge on the pharmacological treatment of intrahepatic cholestasis of pregnancy.

Keywords: Bile acids, cholestasis, pregnancy, pruritus, treatment, ursodeoxycholic acid, S-adenosyl-methionine, glucocorticoid therapy, Elevated Liver, Low Platelets, Haemolysis