There is no cure for OC. Treatment is currently aimed at reducing the build-up of bile salts in the
blood to relieve the itching and to protect the baby. Following diagnosis of OC doctors may carry
out liver function tests on a weekly basis to monitor your condition. This may involve more trips to hospital which can be either reassuring or unsettling at this time. If your itching persists, doctors are advised to run these tests every one or two weeks.
A number of medications may be used in your treatment. As yet, a specific medication to manage OC is not available although clinical studies are in progress. Some of the medications listed below are primarily used for other conditions and agreement about their effectiveness in OC is not settled.
Ursodeoxycholic acid (URSO or UDCA) is the most commonly prescribed medication to relieve itching caused by OC. It is still being evaluated for use in pregnancy and is prescribed with ‘informed consent’ (that is, taken with the knowledge that it is not licensed or clinically proven). It has been shown to be effective in women with higher levels of bile acids, but wider research studies need to be carried out.
URSO is a naturally occurring bile acid which accounts for 1% of circulating bile acids in your
body. Taken orally in capsule form, this proportion can be increased to 50% to provide more
protection for the liver by displacing more harmful bile acids and improving the flow of bile.
Dexamethasone (sold as Decadron) is a steroid sometimes prescribed to increase the maturity of the baby’s lungs so the baby can be delivered earlier. Its use is aimed at reducing your level of hormone production and to help relieve itching. However, wider studies are needed to establish the safety and effectiveness of dexamethasone.
Cholestyramine has been proven to reduce itching in some women but may lead to further vitamin K deficiency.
Chlorpheniramine (Piriton) is an antihistamine that may be prescribed to help you sleep at night but is not considered to have much effect on your itching.
Vitamin K is a fat-soluble vitamin absorbed in your diet that is essential for blood coagulation (clotting). Following birth in OC your baby may require an injection of vitamin K.
You are likely to receive a daily supplement of vitamin K in the form of a water-soluble tablet
(rather than by injection) to help prevent bleeding during delivery.