Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: Good, but can do better

摘要

Intrahepatic cholestasis of pregnancy (ICP) may cause considerable discomfort to the child-bearing mother because of severe pruritus and it may have deleterious consequences for the fetus by increasing the rate of prematurity, fetal distress and intrauterine fetal death (IUFD) [1]. An efficient, safe and well tolerated medical treatment is thus highly needed. To-date, ursodeoxycholic acid (UDCA) is widely prescribed: several controlled studies have shown that it relieves pruritus and may improve fetal outcome. However, most of these studies are small and a previous meta-analysis has questioned the effectiveness of UDCA in this disorder [2], (update available on www.cochrane.org). Moreover, the benefit of UDCA on severe fetal outcome has never been demonstrated. The new meta-analysis conducted by Bacq et al. [3] is therefore of considerable interest.