Table 8

Impact of management of intrahepatic cholestasis on stillbirth and perinatal mortality

Source

Location and Type of Study

Intervention

Stillbirths/Perinatal Outcomes


Intervention studies


Binder et al. 2006 [82]

Czech Republic.

RCT. Singleton pregnancies (N = 78) < 36 wks with a moderate or severe form of cholestasis recruited 1999–2004.

Compared the impact among three groups [SAMe (S-adenosyl-L-methionine) monotherapy (group 1), UDCA (ursodeoxycholic acid) (group 2), and combined therapy (group 3)] on PMR.

PMR: 0/25 vs. 0/26 vs. 0/27 in groups 1, 2 and 3, respectively [NS]


Glantz et al. 2005 [83]

Sweden.

Double-blind, placebo-controlled RCT. Pregnant women (N = 130; N = 47 UDCA, N = 36 dexamethasone, N = 47 placebo) with cholestasis.

Compared the impact on perinatal outcomes of treatment of cholestasis with UDCA (intervention #1), or dexamethasone (intervention #2), vs. placebo (controls).

Fetal death (miscarriage + SB): 0/47 vs. 0/36 vs. 1/47 in intervention group #1, intervention group #2, and controls, respectively.


Palma et al. 1997 [84]

Chile. Secondary case-referral center.

RCT. Pregnant women (N = 15) with early-onset obstetric cholestasis.

Compared the impact on perinatal outcomes of treatment with UDCA (intervention) vs. placebo (controls).

SBR: 0/8 vs. 1/7 in intervention vs. control groups, respectively.


Roncaglia et al. 2002 [85]

Italy (Milan). University hospital.

Intervention trial using prospective cases. Pregnant women (N = 218) with obstetric cholestasis and historical series data.

Compared the effect of a management protocol for cholestasis incorporating transcervical amnioscopy, standard monitoring of fetal well-being with 2× weekly non-stress testing and AFI indices, and induction of labour at 37 weeks if high-risk (intervention) vs. historical controls on obstetric outcome.

SBR: 0/218 vs. 14/888 in intervention vs. control groups, respectively (P = 0.045).


Menezes et al. BMC Pregnancy and Childbirth 2009 9(Suppl 1):S4   doi:10.1186/1471-2393-9-S1-S4

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