Treatment of cholestasis of pregnancy
Treatment differs between intrahepatic and extrahepatic cholestasis. In intrahepatic cholestasis, the condition is closely linked to pregnancy and is unlikely to go away until delivery. In most cases, delivery can be postponed until the 37th week of pregnancy and then delivery is induced. Nevertheless, some medications can be of value in controlling troublesome symptoms including pruritis. Many medications can be used including phenobarbital and dexamethasone which is a steroid. The most effective is phenobarbital for itching. Other medications can be given to improve the flow of bile including UDCA and with it, antihistamines like Diphenhydramine may be given to both improve itching and induce sleeping in pregnant women experiencing insomnia because of itching.
Surgical care is exclusively done for extrahepatic cholestasis. If a stone is obstructing the common bile duct completely, then surgery must be done to relieve the obstruction. Removal of the common bile duct stones can be done using a special endoscope, and removal of the gall bladder may be done. Removal of the gallbladder may be postponed if there are no symptoms to avoid pregnancy problems. All in all, surgery is decided based on the condition, and it can still be done safely in pregnancy under expert hands.
It is also essential to follow-up on your baby’s condition and to exclude other causes of jaundice which can be injurious to your baby including preeclampsia, which can cause liver damage and jaundice in a few cases.
