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Although a benign condition for the mother (other than the inexorable pruritus), intrahepatic cholestasis may decrease fetal survival and increase the risk of prematurity. Treatment fatty acid definition is supportive with bile salt-binding agents such as cholestyramine. Ursodeoxycholic acid therapy improves bile formation, perhaps washing out "toxic" bile acids fatty acid definition and pruritogenic agents. S-adenosylmethionine, which alters membrane fluidity, and rifampin, which increases the excretion of pruritogenic agents, also work. Treatment for cholestasis and pruritus, however, generally is unsatisfactory. Delivery should occur as soon as fetal lung maturity is documented, to prevent the increased risk fatty acid definition of stillbirth. Parenteral vitamin K may be needed to correct a prothrombin deficiency.
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