Obstetric
cholestasis (OC) : How to treat pruritus and how to plan delivery?? Hepatic USG
to exclude any G B stone. Above all Inj
Vit K inj 2 such per week or 1 tab Vitamin K OD(water soluble), May supplement
with Tab Phenergan for pruritus if Dermocalm lotion does not improve her
pruritus and disturbs her sleep & if
unhappy with UDCA up to1500 mg OD, third drug is Rifampicin (detoxifies bile
acids and prevents further liver injury), fourth drug is ? Decadron 12 mg
orally is of questionable efficacy ..5th agent is Cholestyramine (in the dose
of $Gm TDS) / activated charcoal are rarely enquired. May terminate at 37 weeks
as sudden IUFD is not uncommon inspite of adequate therapy, Caused of IUFD is still uncertain. A note of caution: If Bile
acid is persistently > 40picomol?l then urgent delivery at 36 weeks,
No oral contraceptives
in life. May recur in next pregancy.
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