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Pregnant. Started Severe Itching And Suggested Udilive 300 Mg. Liver Function Test Done. What To Do?

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Posted on Thu, 29 Nov 2012
Question: Dear Doctor, I'm Currently 27 weeks pregnant. I had a sever itching at around 24 weeks and my gyane suggested me to take udilive 300 mg and to do a Liver function test. I went next day for LFT and results are Total bilirubin=0.6 mg/dl, SGOT 58 U/L, SGPT 91 U/L, Alkaline Phospatase 106. I took Udilive 300 mg tablet for a week and conducted LFT again with results total bilirubin: 0.37mg/dl, albumin:2.8, SGOT 63 U/L, SGPT 101 , alkaline phosphatase 132 U/L. My Gynae said to continue Udilive 300 mg thrice in day and conduct LFT after a month. If SGOT/SGPT results didnt improved then she has to put steriod injection and there are chances of preterm birth. Kindly please suggest what to do?
doctor
Answered by Dr. Asra Ishtiaq Ahmed (22 minutes later)
Hello there.

Thanks for writing.

You are taking the right treatment.

The condition you have is known as Cholestasis of pregnancy.

Pregnancy hormones affect gallbladder function, resulting in slowing or stopping the flow of bile. When the bile flow is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream.
These elevated bile acids then cause itching, fatigue, dark urine and rarely jaundice.

It may also increase the risks for fetal distress, preterm birth, or stillbirth.

This is the reason your doctor would give you steroid injection if your LFT does not improve.
Steroid injections are given to those in whom preterm (premature) delivery is anticipated. It helps in acceleration of the process of lung maturity of the baby. Fetal Lung maturation is complete only after 34 weeks so in the event you have a risk of delivering before this period, steroids are given so as to make the fetus capable of breathing once born. Also it reduces chances of intraventricular(brain) hemorrhage in premature babies.

Udiliv will not treat the condition but it will make the elevated bile acids soluble which can be excreted thus lowering the levels of bile acids. The symptoms of elevated bile acids then improve. There is no harm by taking udiliv.

Cholestasis improves once you deliver.

The things you need to be careful about are the baby movements and growth.

Regular check ups with your doctor is a must.

Monthly LFT is also needed.

You should also get periodic Biophysical profile (ultrasound monitoring baby's activities, heart and breathing) and Non stress tests (fetal heart rate tracing) to ensure your baby is doing well. You can discuss with your doctor about the need of these.

In the event you perceive decreased movements, you should see your doctor.

Lactocalamine lotion application can also provide you symptomatic relief in your itching.

Maintain good diet and fluid intake.

Wishing you All the best.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed (9 minutes later)
I'm Currently in Roorkee. In case of premature birth where I can get the best neonatal facilities. Also, there is no itching since then and my appetite is normal with no other symptoms.
doctor
Answered by Dr. Asra Ishtiaq Ahmed (18 minutes later)
Thanks for writing back.

It is good to know that you have no symptoms now. It is probably because of the use of udiliv.

You can get good neonatal facilities along with a gynecologist in any tertiary(referral)/multispeciality hospital.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Asra Ishtiaq Ahmed

OBGYN

Practicing since :2008

Answered : 689 Questions

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Pregnant. Started Severe Itching And Suggested Udilive 300 Mg. Liver Function Test Done. What To Do?

Hello there.

Thanks for writing.

You are taking the right treatment.

The condition you have is known as Cholestasis of pregnancy.

Pregnancy hormones affect gallbladder function, resulting in slowing or stopping the flow of bile. When the bile flow is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream.
These elevated bile acids then cause itching, fatigue, dark urine and rarely jaundice.

It may also increase the risks for fetal distress, preterm birth, or stillbirth.

This is the reason your doctor would give you steroid injection if your LFT does not improve.
Steroid injections are given to those in whom preterm (premature) delivery is anticipated. It helps in acceleration of the process of lung maturity of the baby. Fetal Lung maturation is complete only after 34 weeks so in the event you have a risk of delivering before this period, steroids are given so as to make the fetus capable of breathing once born. Also it reduces chances of intraventricular(brain) hemorrhage in premature babies.

Udiliv will not treat the condition but it will make the elevated bile acids soluble which can be excreted thus lowering the levels of bile acids. The symptoms of elevated bile acids then improve. There is no harm by taking udiliv.

Cholestasis improves once you deliver.

The things you need to be careful about are the baby movements and growth.

Regular check ups with your doctor is a must.

Monthly LFT is also needed.

You should also get periodic Biophysical profile (ultrasound monitoring baby's activities, heart and breathing) and Non stress tests (fetal heart rate tracing) to ensure your baby is doing well. You can discuss with your doctor about the need of these.

In the event you perceive decreased movements, you should see your doctor.

Lactocalamine lotion application can also provide you symptomatic relief in your itching.

Maintain good diet and fluid intake.

Wishing you All the best.

Take care.