Effect of Ursodeoxycholic Acid Alone Versus Ursodeoxycholic Acid and Rifampicin in Obstetric Cholestasis
DOI:
https://doi.org/10.36283/ziun-pjmd14-3/040Keywords:
Ursodeoxycholic acid, Intrahepatic Cholestasis of Pregnancy, Rifampin, Pruritus, Liver Function TestsAbstract
Background: Intrahepatic cholestasis of pregnancy (ICP) is a common liver disorder in pregnancy, associated with pruritus, elevated bile acids, and increased risk of adverse perinatal outcomes. While Ursodeoxycholic Acid (UDCA) is the first-line treatment, some patients respond inadequately. This study aimed to compare the effectiveness of UDCA alone versus UDCA combined with Rifampicin in reducing clinical symptoms and improving biochemical markers in women with ICP.
Methods: This quasi-experimental study was conducted at the Department of Obstetrics and Gynecology, Maternal and Child Health Hospital, Unit 1, PIMS Islamabad, from August 1, 2022, to January 31, 2023. A total of 122 pregnant women diagnosed with ICP were enrolled using non-probability consecutive sampling and divided into two groups. Group A received UDCA alone, and Group B received UDCA plus Rifampicin. Inclusion criteria were singleton pregnancy, gestational age 24–36 weeks, serum bile acids >10 µmol/L, and/or raised liver enzymes. Data were analyzed using SPSS version 21, with independent t-tests for continuous variables and chi-square tests for categorical data. A p-value < 0.05 was considered statistically significant.
Results: The combination therapy group showed significantly greater reductions in pruritus (p = 0.023), serum bile acids, liver enzymes, and bilirubin levels (p < 0.0001) at 2 and 4 weeks compared to UDCA alone.
Conclusion: Rifampicin combined with UDCA is more effective than UDCA monotherapy in improving both clinical and biochemical outcomes in ICP.
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