Still in Search of an Effective Treatment for Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is diagnosed based on presence of pruritus, elevated total serum bile acid concentration, and/or elevated aminotransferases, as well as absence of another disease that could produce similar findings. To assess the efficacy of ursodeoxycholic acid for managing ICP, U.K. investigators randomized 605 women at >20 weeks' gestation with ICP to ursodeoxycholic acid (500 mg twice daily) or placebo.

Ursodeoxycholic acid and placebo resulted in similar rates of preterm birth (17% and 20%; risk ratio, 0.79) and admission to the neonatal intensive care unit (14% and 17%; RR, 0.81). Ursodeoxycholic acid reduced pruritis by 13% (P<0.005) and increased serum bile acid concentration by 21% (P<0.03). Intrauterine …