Intrahepatic Cholestasis of Pregnancy, Worsening After Dexamethasone

Kretowicz, E. M.; Mclntyre, H David

doi:10.1111/j.1479-828x.1994.tb02695.x

Cited by 21 publications

(7 citation statements)

References 5 publications

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“…In addition liver biochemistry, including the serum bile acid level, was improved and symptoms did not recur on cessation of treatment [199] . However, this was not supported by subsequent studies [189,200,201] .…”

Section: Drugsmentioning

confidence: 69%

Intrahepatic cholestasis of pregnancy

Geenes

Williamson

2009

WJG

547

490

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Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus in the third trimester, raised serum bile acids and increased rates of adverse fetal outcomes. The etiology of ICP is complex and not fully understood, but it is likely to result from the cholestatic effects of reproductive hormones and their metabolites in genetically susceptible women. Equally unclear are the mechanisms by which the fetal complications occur. This article reviews the epidemiology, clinical features, diagnosis, etiology and management of ICP.

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Section: Drugsmentioning

confidence: 69%

Intrahepatic cholestasis of pregnancy

Geenes

Williamson

2009

WJG

547

490

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“…One case report has documented worsening of ICP following treatment with dexamethasone. 65 Several concerns exist with the use of dexamethasone. In the rat model, antenatal administration of dexamethasone resulted in decreased insulin sensitivity in offspring.…”

Section: Dexamethasonementioning

confidence: 99%

Cholestasis of Pregnancy

Pathak

Sheibani

Lee

2010

Obstetrics and Gynecology Clinics of North America

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“…Some patients (10%) report diarrhea, mild stomach pain, sleep disorder, dizziness, or headache [39]. Special points There is a case report of worsening cholestasis after treatment with dexamethasone [48]. Leukocytosis has been reported in infants exposed to dexamethasone antenatally, but white blood cell counts return to normal in about 1 week.…”

Section: Main Drug Interactions See the Section On Glucocorticoidsmentioning

confidence: 97%

Intrahepatic cholestasis of pregnancy

Lammert

Marschall

Matern

2003

Curr Treat Options Gastro

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Intrahepatic cholestasis of pregnancy (or obstetric cholestasis) is a liver disorder that occurs in late pregnancy. Despite the potential adverse maternal and fetal/neonatal outcomes, cholestasis of pregnancy is often neglected and treated expectantly. More research is needed to improve the molecular and genetic understanding of the disease and to define a safe and effective medical treatment that improves clinical outcome. Ursodeoxycholic acid is considered to be a safe treatment option in the third trimester, but further randomized controlled trials are needed before ursodeoxycholic acid treatment can be generally recommended. Ursodeoxycholic acid is preferentially administered to patients with severe cholestasis (onset before week 33 or serum bile acid levels > 70 mmol/L) or to patients with a history of sudden fetal death, while maintaining close obstetric and regular biochemical surveillance (transaminases, bilirubin, and bile acid levels). Ursodeoxycholic acid can decrease pruritus and ameliorate liver tests, but effects on obstetric complications are ambiguous. S-Adenosylmethionine, dexamethasone, and cholestyramine can provide some relief of itching. Because none of these drugs have been shown to be harmful to mother or fetus, the individual woman and her clinician may decide whether to try one of the treatments described.

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Intrahepatic Cholestasis of Pregnancy, Worsening After Dexamethasone

Cited by 21 publications

References 5 publications

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy

Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy

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