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Intrahepatic cholestasis complicates 0.01 to 0.02 percent of pregnancies in North America, 1 to 1.5 percent of pregnancies in Sweden and 5 to 21 pregnancyproblem percent of pregnancies in Chile.20 The disease is rare in black patients.20 A strong family pregnancyproblem history of cholestasis of pregnancy is typically described by the patient.20 Kindred studies reveal alterations in bromosulfophthalein clearance following estrogen treatment in both male and female relatives of women affected by intrahepatic cholestasis of pregnancy.19 Multiple medications have been tried as treatments for cholestasis of pregnancy.19 Parenteral vitamin K (phytonadione; AquaMephyton) supplementation is advocated in patients with pregnancyproblem prolonged cholestasis (secondary to malabsorption of this fat-soluble vitamin). Ursodeoxycholic acid (Actigall), given at dosages of 15 mg per kg per day, has been the most successful therapy for cholestasis of pregnancy, as it ameliorates both the pruritus and liver function abnormalities and is well-tolerated by both mother and fetus.21
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