Author: L. V. Netrunenko, head. Gastroenterology Department of the Lugansk Regional Clinical Hospital, Chief Freelance Gastroenterologist of the Luhansk Regional State Administration
In our country, it is traditionally considered that an obstetrician-gynecologist should solve most of the health problems of a woman during pregnancy. This is not entirely true, since during pregnancy a woman may have an exacerbation of existing chronic diseases of the internal organs, complications may appear, and in the presence of risk factors, pathological conditions may arise, the provoking factor for which is pregnancy. That is why the joint observation and management of the patient by both the therapist and the obstetrician-gynecologist is extremely important for saving the life and health of the mother and her unborn baby. One such disease that occurs only during pregnancy is intrahepatic cholestasis of pregnancy.
Currently, practically the only means of eliminating intrahepatic cholestasis in this category of patients is ursodeoxycholic acid (UDCA). UDCA is an integral part of the human bile acid pool, a natural and non-toxic hydrophilic bile acid. Its main effects are cytoprotective and anticholestatic, due to the ability of UDCA to displace more toxic (such as chenodeoxycholic, deoxycholic, lithocholic) bile acids from bile by inhibiting the absorption of these acids in the intestine. In addition, UDCA has an immunomodulatory and anti-inflammatory effect due to the suppression of the expression of pro-inflammatory cytokines. UDCA has anti-apoptotic and hypocholesterolemic effects, it inhibits the absorption of cholesterol from the intestine into the blood, reduces its synthesis in the liver and, thus, leads to a decrease in the saturation of bile with cholesterol and a decrease in its lithogenic index.
UDCA drugs are available on the Ukrainian market, both in the form of the original drug and its generic copies, and in each case, the doctor has the opportunity to choose, focusing on personal experience and recommendations from leading experts on this issue.
Published in the journal «District Doctor» № 7’2014