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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