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Treatments and drugs
By Mayo Clinic staffTreatment for cholestasis of pregnancy has two goals: relieve itching and prevent complications.
Relieving itching
To soothe intense itching, your health care provider may recommend:
- Taking a prescription medication, such as ursodiol (Actigall, Urso), to relieve itching and decrease the absorption of bile
- Using anti-itch creams or lotions that contain corticosteroids
- Soaking itchy areas in lukewarm water
Using too much corticosteroid cream — as you might be tempted to do to relieve the intense itching associated with this condition — may pose a risk to your developing baby. Follow your doctor's instructions for using over-the-counter anti-itch creams, if he or she recommends that you use them.
Preventing complications
To make sure your condition doesn't lead to complications with your pregnancy, your health care provider may recommend:
- Regular blood tests to monitor how well your liver is working and measure the amount of bile in your blood.
- Periodic ultrasounds and nonstress tests to monitor your baby's well-being. During an ultrasound, high-frequency sound waves are translated into a pattern of light and dark areas — creating an image of your baby on a monitor. During a nonstress test, your health care provider will check how often your baby moves in a certain period of time and how much his or her heart rate increases with movement.
- Early induction of labor. Even if the prenatal tests appear normal, your health care provider may suggest inducing labor early — at or near 38 weeks, or even earlier if cholestasis is severe — which is sometimes the best and only way to prevent complications.
References
- Bacq Y, et al. Cholestasis of pregnancy. http://www.uptodate.com/home/index.html. Accessed Aug. 31, 2011.
- Geenes V, et al. Intrahepatic cholestasis of pregnancy. World Journal of Gastroenterology. 2009;15:2049.
- Liver disorders in pregnancy. March of Dimes. http://www.marchofdimes.com/professionals/14332_14543.asp. Accessed Sept. 1, 2011.
- Riely CA, et al. Intrahepatic cholestasis of pregnancy. Clinics in Liver Disease. 2004;8:167.
- Skin conditions during pregnancy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp169.cfm. Accessed Sept. 6, 2011.
- Cappell MS. Hepatic and gastrointestinal diseases. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-443-06930-7&eid=4-u1.0-B978-0-443-06930-7..50045-1. Accessed Sept. 6, 2011.
- Burrows R, et al. Interventions for treating cholestasis in pregnancy. Cochrane Database of Systematic Reviews. 2009:CD000493. http://www2.cochrane.org/reviews. Accessed Sept. 6, 2011.
- SAMe. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Sept. 6, 2011.
- Pathak B, et al. Cholestasis of pregnancy. Obstetrics and Gynecology Clinics of North America. 2010;37:269.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2011.
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