THE TREATMENT OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY BY DEXAMETHASONE

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.