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Evid Based Med doi:10.1136/eb-2013-101298
  • Therapeutics
  • Systematic review and meta-analysis

Ursodeoxycholic acid for intrahepatic cholestasis of pregnancy: good for the mother, not bad for the baby

  1. Paula White2
  1. 1Division of Hepatology, Mayo Clinic, Phoenix, Arizona, USA
  2. 2Department of OB-Gyn, Loyola University Chicago, Maywood, Illinois, USA
  1. Correspondence to: Dr Elizabeth J Carey
    Division of Hepatology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA; carey.elizabeth{at}mayo.edu

Commentary on: Bacq Y, Sentilhes L, Reyes HB, et al. Efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy: a meta-analysis. Gastroenterology 2012;143:1492–501.

Context

Intrahepatic cholestasis of pregnancy (ICP) is a heritable disease of pregnancy resulting in elevation of serum bile acids, pruritus and increased risk of poor fetal outcomes. It always resolves after delivery, but pruritus can be a cause of severe distress for the mother, and the fetus is at increased risk of intrauterine demise. The prevalence of ICP varies greatly by ethnicity and geography: rates of over 25% have been reported in South American Indians, although in most areas the prevalence is less than 2%.1 ,2

Ursodeoxycholic acid (UDCA) is a naturally occurring hydrophilic bile acid used in a variety of cholestatic liver diseases. The exact mechanism of benefit is not completely understood, but it is thought to work by …

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