Treatment of cholestasis of pregnancy

I believe everyone is unfamiliar with the disease of cholestasis of pregnancy. This disease mostly occurs in women during pregnancy. Once this disease occurs, everyone will inevitably be nervous and worried about the condition of the fetus in the womb. So how should we treat this disease? The following article describes the treatment method of this disease. Let’s follow me to learn about it.

Treatment:

The goals of treatment are to relieve itching symptoms, improve liver function, lower blood bile acid levels, strengthen monitoring of the fetal intrauterine condition, prolong gestational age, and improve pregnancy outcomes.

(1) General treatment: Appropriate bed rest, lying on the left side to increase placental blood flow, intermittent oxygen inhalation, hypertonic glucose, vitamins and energy mixtures are given to protect the liver and improve the fetus's tolerance to hypoxia. Regularly recheck liver function and serum bile acid to understand the condition.

(2) Drug treatment: The drugs that can alleviate the clinical symptoms of pregnant women and improve the biochemical indicators of cholestasis and perinatal prognosis include:

Ursodeoxycholic acid: first-line drug for the treatment of ICP. Both pruritus symptoms and biochemical indicators were significantly improved. During treatment, liver function was checked every 1-2 weeks to detect changes in biochemical indicators.

S-adenosylmethionine: a second-line clinical drug for the treatment of ICP.

Dexamethasone: It can promote fetal lung maturity and prevent premature infants from experiencing respiratory distress syndrome. It is used before 34 weeks of pregnancy for those who are estimated to be likely to deliver prematurely within 7 days.

(3) Auxiliary treatment:

Liver protection therapy: On the basis of bile acid lowering therapy, oral or intravenous drugs are used for liver protection therapy;

Improve itching symptoms: Giving certain topical medications (such as calamine lotion) can improve skin itching symptoms;

Application of vitamin K: Vitamin K can be given to prevent postpartum hemorrhage.

Chinese medicine treatment

(4) Obstetric treatment:

Prenatal monitoring includes weekly non-stimulated fetal heart rate monitoring (NST) tests starting from the 34th week of pregnancy, and fetal biophysical assessment when necessary, in order to detect hidden fetal hypoxia early. If the condition is serious, the patient will be admitted to the hospital early to prepare for delivery. Count the fetal movements every day. If there are less than 10 movements within 12 hours, you should be alert to fetal distress. Regular ultrasound examinations should be performed to check for oligohydramnios.

Timely termination of pregnancy: ICP is not an indication for cesarean section. However, because ICP is prone to acute fetal hypoxia and stillbirth, there is currently no effective monitoring method to predict fetal hypoxia. Most scholars recommend that ICP patients induce labor at 37-38 weeks of gestation, actively terminate the pregnancy, and strengthen fetal monitoring during delivery. If treatment of severe ICP is ineffective and combined with multiple births, severe preeclampsia, etc., cesarean section can be performed to terminate the pregnancy.

The above introduces the treatment method of gestational cholestasis for women who are pregnant. I believe everyone has already understood the treatment method of this disease. Therefore, when you encounter this disease, you should pay attention to your eating habits, especially pregnant women should not stay up late and do some moderate aerobic exercise to improve their physical fitness.