Efectividad de la terapia combinada de ácido ursodesoxicólico y s-adenosil metionina versus monoterapia con ácido ursodesoxicólico en el manejo de gestantes con colestasis intrahepática: revisión sistemática.
Palabras clave:
Ácido Ursodesoxicólico, Colestasis Intrahepática, Embarazo, S-Adenosilmetionina.Resumen
Antecedentes: La colestasis intrahepática en embarazadas es una complicación de la gestación que suele ser común, se asocia con complicaciones perinatales. La efectividad de ácido ursodesoxicólico sigue en discusión a pesar de ser el tratamiento de elección. Se ha propuesto una alternativa combinada con S-Adenosil Metionina, con efectos sinérgicos eficaces; sin embargo, la evidencia es limitada.
Objetivo general: Analizar la efectividad de la terapia combinada de AUDC y SAMe frente a la monoterapia con AUDC en gestantes con CIE.
Metodología: se realizó una revisión sistemática de la literatura en bases de datos digitales, se incluyó artículos en inglés y español que han sido previamente publicados en revistas indexadas de alto impacto. Se constató que los artículos cumplan con los criterios de inclusión y se evaluó el riesgo de sesgo con herramientas específicas.
Resultados: La monoterapia con AUDC evidenció mejoría significativa del prurito y reducción de ácidos biliares, ALT y AST. La terapia combinada también fue eficaz, mostrando en algunos estudios mayor descenso de parámetros bioquímicos, aunque sin diferencias significativas en desenlaces perinatales.
Conclusión: El AUDC continúa siendo un tratamiento efectivo y seguro en la CIE, mientras que la combinación con SAMe puede considerarse como alternativa complementaria, sin demostrar superioridad clínica en los parámetros evaluados.
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Derechos de autor 2026 Johanna Salomé Muñoz-Pauta, Joaquín Bernardo Orellana-Solís, Santiago Picón-Saavedra, Jeanneth Patricia Tapia-Cárdenas
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.