Relationship between treatment of intrahepatic cholestasis during pregnancy and prognosis of prenatal infant

To evaluate the effect of ursodeoxycholic acid (UDCA) and dexamethasone (DX) on intrahepatic cholestasis during pregnancy and prognosis of the perinatal infant. Methods: 126 patients were randomly divided into the UDCA group (Group A), DX group (Group B) and the control group (Group C), with 42 patients in each group. And patients in the 3 groups were further divided into two sub-groups in accordance with the level of serum bile acid. There were 30 cases in A 1, 27 cases in B 1, and 29 cases in C 1, with 10 μmol/LTBA≤50 μmol/L. And there were 12 cases in Group A 2, 15 cases in Group B 2, and 13 cases in Group C 2 respectively, with TBA50 μmol/L. Patients in Group A were treated with UDCA, at a dose of 100 mg, 3 times a day for a succession of 14 days. Patients in Group B were treated with DX, at a dose of 3 mg, also 3 times a day for a succession of 10 days, after which medication was reduced and finally terminated. Patients in Group C were given vitamin C, 0.3 g, 3 times a day for a succession of 14 days. Results: For patients in Group A and Group B, the symptom of pruritus was released significantly after treatment (P 0.05), while symptom remained unchanged for patients in Group C. The level of serum bile acid in Group A and B reduced significantly ( P0.05), with the reduction in TBA being greater in A 2 than that in B 2 (P0.05), while that of Group C rose slightly ( P0.05). Incidence of premature birth, fetal distress and asphyxia of infant was positively correlated with the level of serum bile acid, with the incidence rate significantly lower in Group A and B than that in Group C (P0.05). And there was no significant difference in the incidence of premature birth, fetal distress and asphyxia of infant in the lower TBA groups (Group A 1 and B 1). For the higher TBA groups (Group A 2 and B 2), there was significant difference in the incidence of premature birth, fetal distress and asphyxia of infant (P0.05). Conclusion: UDCA and DX are all effective for the treatment of intrahepatic cholestasis during pregnancy. They can reduce incidence of premature birth, fetal distress and asphyxia of infant. For patients with higher TBA level, the effect of UDCA is better than DX, but vitamin C alone is of no effect for the treatment of intrahepatic cholestasis during pregnancy.