The treatment of intrahepatic cholestasis of pregnancy by dexamethasone.

ABSTRACT

OBJECTIVE: To investigate whether dexamethasone suppression of fetoplacental oestrogen production can reduce obstetric cholestasis. DESIGN: Observational study. SETTING: Department of Obstetrics and Gynaecology, University of Tampere, Finland. SUBJECTS: 10 women, at between 28 and 37 weeks gestation, with intrahepatic cholestasis of pregnancy. INTERVENTIONS: Treatment with 12 mg oral dexamethasone daily for 7 days, after which the therapy was gradually discontinued over 3 days. MAIN OUTCOME MEASURES: Serum oestriol, oestradiol, total bile acids and ALAT were measured before and during therapy and on days 4 and 7 and ALAT also on day 12. Differences were tested by paired t test. RESULTS: Itching disappeared or was relieved in all patients. Serum oestriol level fell significantly by day 1 of treatment, serum oestradiol and total bile acid levels by day 4 and ALAT by day 12 from the beginning of the therapy. CONCLUSION: Dexamethasone is a drug of choice in the treatment of intrahepatic cholestasis of pregnancy.