Treatment for cholestasis of pregnancy aims to relieve itching and prevent complications.
To soothe intense itching, your pregnancy care provider may recommend:
- Taking the prescription medication ursodiol (Actigall, Urso), which helps decrease the level of bile in the mother's bloodstream, relieves itchiness and may reduce complications for the baby
- Soaking itchy areas in lukewarm water
You might be tempted to take an antihistamine or use an anti-itch (corticosteroid) cream to relieve the intense itching associated with this condition. Antihistamines are often ineffective and may pose risks to your developing baby. And if they do work, you may not feel the need to see your pregnancy care provider, delaying effective diagnosis and treatment. Corticosteroid creams and lotions don't work to relieve the itching of cholestasis of pregnancy. In addition, using too much corticosteroid cream may pose a risk to the baby.
Because complications related to the baby's health can be serious, your pregnancy care provider may recommend close monitoring of your baby during pregnancy. Measures your pregnancy care provider might take include:
Aug. 16, 2014
- Nonstress tests and biophysical profile scores. These tests help monitor your baby's well-being. During a nonstress test, your pregnancy 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. The biophysical profile provides information regarding the volume of amniotic fluid, as well as fetal muscle tone and activity. While these tests can be reassuring, they can't really predict the risk of preterm birth or other complications associated with cholestasis of pregnancy.
- Early induction of labor. Even if the prenatal tests appear normal, your pregnancy care provider may suggest inducing labor early — around 37 weeks or so. Because it's hard to predict when fetal death might occur, early delivery is sometimes the best and only way to prevent complications.
- Lindor KD, et al. Cholestasis of pregnancy. http://www.uptodate.com/home. Accessed May 12, 2014.
- Geenes V, et al. Intrahepatic cholestasis of pregnancy. World Journal of Gastroenterology. 2009;15:2049.
- Liver disorders. March of Dimes. http://www.marchofdimes.com/pregnancy/liver-disorders.aspx. Accessed May 12, 2014.
- Azzaroli F, et al. The pharmacological management of intrahepatic cholestasis of pregnancy. Current Clinical Pharmacology. 2011;6:12.
- Frequently asked questions. Pregnancy FAQ169. Skin conditions during pregnancy. American College of Obstetricians and Gynecologists. https://www.acog.org/~/media/For%20Patients/faq169.pdf?dmc=1&ts=20140613T1059562167. Accessed May 15, 2014.
- Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed May 15, 2014.
- Gurung V, et al. Interventions for treating cholestasis in pregnancy. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000493.pub2/abstract. Accessed May 16, 2014.
- SAMe. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 15, 2014.
- 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. May 21, 2014.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. May 30, 2014.
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