Re: Gestational pruritus in 3rd trimester and intrauterine fetal
From: Peter Wein (pwein@unimelb.edu.au)
Sun Aug 7 03:42:59 2005
Ursodeoxycholic acid much better - there has been RCT showing improved
outcome in IHCP with urso, much better tolerated.
--
Peter Wein
art fougner, md wrote:
>Cholestyramine resin may be useful in this situation.
>
>art
>
>At Thu, 04 Aug 2005, Robert J. Carpenter, Jr. MD wrote:
>
>>The data concerning cholestasis and pruritis gravidarum is a complex bag. The
>>original separation was the presence of pruritis only without abnormality of lifer
>>funcrttions tests (LFT). That has a low probability of IUFD but it does occur. The real
>>question is what degree compared to the background of normal patients. With
>>elevated LFT then the IUFD rate increases and surveillance is indicated. The
>>Europeans use an agent but name not in head at this moment. Best recall study
>>about 24 months ago from either Sweden or Norway. Go to PubMed and search will
>>pull up the article.
>>
>>I use fetal mvement counts as per the method of Eliah Sadovsky as my prime
>>surveillance tool. Mom counts for 30 mninutes TID at same time of day and about
>>90-120 minutes post meal. After 4 days of counts the average is taken and that is the
>>"truth" If there is a decrease by 50% on 2 consecutive counts then other testing
>>usually CST is done. Mom's appreciation of movem,ent is your best index of well
>>being.
>>
>>If severe pruritis is present at 30 weeks then some surveillance is indicated as Dan
>>indicated.
>>
>>On 4 Aug 2005 at 21:27, R. Daniel Braun wrote:
>>
>>>There are other papers back before that one which say the same thing.
>>>We start fetal surveillane at 30 weeks and deliver at 35 weeks in our
>>>patients with Chlestasis of pregnancy. Dan
>>>
>>> On 8/4/05, Ricardo Savaris <rsavaris@hcpa.ufrgs.br> wrote:
>>>
>>>>Dear all,
>>>>
>>>>I am a little bit away from the obstetrics front , but I received an
>>>>information about the gestational pruritus in 3rd trimester and
>>>>intrauterine fetal demise. What I found was a series of cases (BJOG,
>>>>2004,Jul;111(7):676-81.) and I don't have access. Nevertheless, it
>>>>doesn't seem to a good evidence. If you give me some literature to
>>>>read would be interesting, but your personal experience would be
>>>>even better.
>>>>
>>>>Ricardo Savaris
>>>>
>>>--
>>>R. Daniel Braun
>>>Kinky for Governor
>>>
>>--
>>Robert J. Carpenter, Jr. MD
>>6624 Fannin, #2720
>>St. Luke's Medical Tower
>>Houston,TX 77030-2339
>>713-795-4600
>>
>
>--
>art fougner, md
>
> "If you don't know where you are going, you will wind up somewhere else."
>Lawrence Peter Berra
>
