Document Detail


Cholestasis of pregnancy.
MedLine Citation:
PMID:  10385057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cholestasis of pregnancy is the commonest liver disease unique to pregnancy and is characterized by pruritus in the mother in late pregnancy, without any skin rashes. This is accompanied by an elevation of the serum bile acids. Liver function test abnormalities may occur. Abdominal pain is not a feature and liver failure does not occur. The diagnosis is made by a suggestive history and exclusion of other causes by the history, serology and an upper abdominal ultrasound. All symptoms and signs should disappear within 4 weeks post-partum; prolonged post-partum courses should prompt a search for other causes, such as primary biliary cirrhosis. The syndrome is associated with a five-fold increased incidence of stillbirth, intra-partum foetal distress and pre-term labour. The reason is not clear and not predictable. The accepted management is induction or delivery at 38 weeks, which has led to a reduction in poor foetal outcome. Preliminary studies using ursodeoxycholic acid show symptomatic and biochemical improvement in most women treated. There is also a suggestion of an improved foetal outcome and treatment should be considered in women who present with the condition earlier in pregnancy.
Authors:
J A McDonald
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  14     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-09-08     Completed Date:  1999-09-08     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  515-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Wollongong Hospital, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Antipruritics / therapeutic use
Cholestasis / complications,  diagnosis*,  drug therapy*,  epidemiology
Cholestyramine Resin / therapeutic use
Dexamethasone / therapeutic use
Female
Fetal Distress / etiology,  prevention & control
Gastrointestinal Agents / therapeutic use
Glucocorticoids / therapeutic use
Humans
Pregnancy
Pregnancy Complications*
Prevalence
Pruritus / diagnosis
S-Adenosylmethionine / therapeutic use
Ursodeoxycholic Acid / therapeutic use
Chemical
Reg. No./Substance:
0/Antipruritics; 0/Gastrointestinal Agents; 0/Glucocorticoids; 11041-12-6/Cholestyramine Resin; 128-13-2/Ursodeoxycholic Acid; 29908-03-0/S-Adenosylmethionine; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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