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How is acute cholestasis treated during pregnancy ?

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Practicing since : 2000
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My 30 yr old daughter has cholestasis in her third pregnancy. She is 11 wks pregnant. After the first child she had to have her gall bladder removed due to gall stones. Her second pregnancy 3 yrs ago started the cholestasis during the 2nd trimester but now she has started at 10 weeks. The recent liver function lab result showed only the ALT elevated (90..high "normal" = 45). Is there any treatment that can be started to keep her and the fetus under control? She has the itching, nausea, and some upper right quadrant back pain (no upper rt abdominal pain). Is there a MD specialist that she should be connected to?
Posted Sat, 21 Apr 2012 in Liver and Gall Bladder
Answered by Dr. Poorna Chandra K.S 16 hours later

Thanks for posting your query.

Acute cholestasis of pregnancy usually manifests with itching in the third trimester of pregnancy but can occur earlier also. Around 60-70% have recurrence in subsequent pregnancies and is commoner if they have underwent cholecystectomy.

While Ursodeoxycholic acid and s-Adenosylmethionine may help only definitive therapy is delivery.

However it is advisable to rule out other causes of cholestasis and your daughter has to be under close medical supervision.

An expert obstetrician / gynecologist (MD Obgyn) should be able to help you out.

Hope I have answered your query adequately. Should you have any additional concern, I am available for follow ups.

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