Question:medium
Treatment of choice for intrahepatic cholestasis in pregnancy is:
Treatment of choice for intrahepatic cholestasis in pregnancy is:
Show Hint
Pick the drug that actually lowers maternal bile acids, not just the itch.
Updated On: Jun 24, 2026
- Cholestyramine
- Ursodiol (ursodeoxycholic acid)
- Corticosteroids (dexamethasone)
- Antihistaminics
Show Solution
The Correct Option is B
Solution and Explanation
The picture is a pregnant woman in late gestation with severe itching, classically of the palms and soles, and a blood test showing raised bile acids. This is intrahepatic cholestasis of pregnancy, and the real concern is not the mother's discomfort but the fetal risk from high bile acid levels. So the ideal drug is one that brings bile acids down.
Ursodeoxycholic acid does exactly that. It promotes bile flow and displaces the toxic, hydrophobic bile acids with a more harmless one, which relieves the itch, improves the liver enzymes, and is regarded as safe to use in pregnancy. For all these reasons it is the accepted first line and treatment of choice.
The other options fall short. Cholestyramine only mops up bile acids in the gut, helps the itch less reliably, and can interfere with fat and vitamin K absorption, raising bleeding risk, so it is a backup at best. Corticosteroids and antihistamines may blunt symptoms a little but do not correct the underlying bile acid load, so neither is the drug of choice.
Therefore the treatment of choice is ursodeoxycholic acid.
\[\boxed{\text{Ursodiol (ursodeoxycholic acid)}}\]
Ursodeoxycholic acid does exactly that. It promotes bile flow and displaces the toxic, hydrophobic bile acids with a more harmless one, which relieves the itch, improves the liver enzymes, and is regarded as safe to use in pregnancy. For all these reasons it is the accepted first line and treatment of choice.
The other options fall short. Cholestyramine only mops up bile acids in the gut, helps the itch less reliably, and can interfere with fat and vitamin K absorption, raising bleeding risk, so it is a backup at best. Corticosteroids and antihistamines may blunt symptoms a little but do not correct the underlying bile acid load, so neither is the drug of choice.
Therefore the treatment of choice is ursodeoxycholic acid.
\[\boxed{\text{Ursodiol (ursodeoxycholic acid)}}\]
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