What medicine is good for cholestasis

Cholestasis is a very common disease among pregnant women in the later stages of pregnancy. It not only damages the liver function of pregnant women, but also directly affects the development of the fetus. In some severe cases, it can cause fetal suffocation or even death. Therefore, pregnant women must pay attention to the phenomenon of cholestasis during pregnancy. If a pregnant woman develops cholestasis, she can take medication for treatment if necessary. So, what medicine should be taken for cholestasis?

General treatment of cholestasis of pregnancy

1. Treatment:

The purpose of treatment is to relieve itching symptoms, restore liver function, and lower blood bile acid levels, with the focus on monitoring the fetal intrauterine condition, promptly detecting fetal hypoxia and taking appropriate measures.

1. General treatment

Provide adequate bed rest, lying on the left side to increase placental blood flow, and give intermittent oxygen inhalation, hypertonic glucose, vitamins and energy mixtures to protect the liver and improve the fetus' tolerance to hypoxia. Regularly recheck liver function, blood bile acid, and bilirubin.

2. Medication

Drugs that can alleviate clinical symptoms of pregnant women, improve biochemical indicators of cholestasis and perinatal prognosis include:

1) Adenosylmethionine is the drug of choice for the treatment of ICP. This drug can prevent cholestasis caused by elevated estrogen and protect the liver of estrogen-sensitive people. Clinically, it can improve the symptoms of ICP and delay further progression of the disease.

2) After taking ursodeoxycholic acid, it inhibits the intestinal reabsorption of hydrophobic bile acid, reduces bile acid, improves the fetal environment, and thus prolongs the gestational age. Both itching symptoms and biochemical indicators were significantly improved.

3) Dexamethasone can induce enzyme activity, reduce the secretion of fetal adrenal dehydroepiandrosterone through the placenta, reduce the production of estrogen, and alleviate cholestasis; it can promote fetal lung maturation and avoid respiratory distress syndrome in premature infants; it can relieve or even eliminate itching symptoms.

4) Phenobarbital This drug can induce enzyme activity and produce cytokine P450, thereby increasing bile flow and improving itching symptoms.

3. Obstetric management

1) Prenatal monitoring: Non-stimulated fetal heart rate monitoring (NST) tests should be performed weekly from the 34th week of pregnancy, and fetal biophysical assessment should be performed when necessary to detect latent fetal hypoxia early. The disappearance of NST and baseline fetal heart rate variability can be used as indicators to predict fetal hypoxia in ICP. 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.

2) Terminate pregnancy in time: Pregnant women with jaundice, who have reached 36 weeks of gestation, have no jaundice, are full-term or have mature fetal lungs, or have significantly decreased placental function or fetal distress should terminate pregnancy in time. Cesarean section should be preferred, as vaginal delivery will aggravate fetal hypoxia and even death.