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Table 8 Impact of management of intrahepatic cholestasis on stillbirth and perinatal mortality

From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

Source Location and Type of Study Intervention Stillbirths/Perinatal Outcomes
Intervention studies
Binder et al. 2006 [82] Czech Republic. RCT. Singleton pregnancies (N = 78) < 36 wks with a moderate or severe form of cholestasis recruited 1999–2004. Compared the impact among three groups [SAMe (S-adenosyl-L-methionine) monotherapy (group 1), UDCA (ursodeoxycholic acid) (group 2), and combined therapy (group 3)] on PMR. PMR: 0/25 vs. 0/26 vs. 0/27 in groups 1, 2 and 3, respectively [NS]
Glantz et al. 2005 [83] Sweden. Double-blind, placebo-controlled RCT. Pregnant women (N = 130; N = 47 UDCA, N = 36 dexamethasone, N = 47 placebo) with cholestasis. Compared the impact on perinatal outcomes of treatment of cholestasis with UDCA (intervention #1), or dexamethasone (intervention #2), vs. placebo (controls). Fetal death (miscarriage + SB): 0/47 vs. 0/36 vs. 1/47 in intervention group #1, intervention group #2, and controls, respectively.
Palma et al. 1997 [84] Chile. Secondary case-referral center. RCT. Pregnant women (N = 15) with early-onset obstetric cholestasis. Compared the impact on perinatal outcomes of treatment with UDCA (intervention) vs. placebo (controls). SBR: 0/8 vs. 1/7 in intervention vs. control groups, respectively.
Roncaglia et al. 2002 [85] Italy (Milan). University hospital. Intervention trial using prospective cases. Pregnant women (N = 218) with obstetric cholestasis and historical series data. Compared the effect of a management protocol for cholestasis incorporating transcervical amnioscopy, standard monitoring of fetal well-being with 2× weekly non-stress testing and AFI indices, and induction of labour at 37 weeks if high-risk (intervention) vs. historical controls on obstetric outcome. SBR: 0/218 vs. 14/888 in intervention vs. control groups, respectively (P = 0.045).