Rifampicin in the treatment of severe intrahepatic cholestasis of pregnancy

Eur J Obstet Gynecol Reprod Biol. 2015 Jun;189:59-63. doi: 10.1016/j.ejogrb.2015.03.020. Epub 2015 Mar 28.

Abstract

Objective: To describe the use of combined ursodeoxycholic acid (UDCA) and rifampicin treatment in intrahepatic cholestasis of pregnancy (ICP).

Study design: A questionnaire survey of 27 women with 28 affected pregnancies identified via the UK and International Obstetric Medicine forum. The clinical case notes of women with ICP treated with combined UDCA and rifampicin therapy were reviewed, and data regarding maternal and perinatal outcomes extracted.

Results: Serum bile acids remained high whilst taking UDCA as monotherapy. In 14 pregnancies (54%) serum bile acids decreased following the introduction of rifampicin. In 10 pregnancies (38%), there was a 50% reduction in serum bile acids. There were no adverse effects reported with either drug.

Conclusions: This is the first report of the use of rifampicin in ICP. The data suggest that combined treatment with UDCA and rifampicin is an effective way of treating women with severe ICP who do not respond to treatment with UDCA alone.

Keywords: Bile acids; Obstetric cholestasis; Pregnancy; Rifampicin; Ursodeoxycholic acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bile Acids and Salts / blood
  • Cholestasis, Intrahepatic / blood
  • Cholestasis, Intrahepatic / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Gestational Age
  • Humans
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / drug therapy*
  • Pregnancy Outcome
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use*
  • Ursodeoxycholic Acid / administration & dosage

Substances

  • Bile Acids and Salts
  • Ursodeoxycholic Acid
  • Rifampin

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy