A prospective study of 18 patients with cholestasis of pregnancy.

In this prospective study we evaluate the role of serum bile acids in the investigation and management of cholestasis of pregnancy in a detailed study of 18 patients. Bile acids were the most sensitive diagnostic test. The increased incidence of fetal distress (33.3% in this series) and meconium-stained fluid (58.3%) did not correlate with very high values of bile acids in maternal serum, umbilical cord serum, or amniotic fluid. Treatment of pruritus with cholestyramine and/or phenobarbital is ineffective in this condition, induction of labor is suggested once fetal lung maturity is established.