妊娠期急性脂肪肝终止妊娠时间对母儿预后的影响

Effects of termination time of pregnancy on maternal and perinatal prognosis in patients with acute fatty liver of pregnancy

目的 :探讨妊娠期急性脂肪肝 (AFLP)的临床特点及终止妊娠时间对母儿预后的影响。方法 :对 1998年1月至 2 0 0 3年 12月本院收治的 2 1例妊娠期急性脂肪肝患者的临床资料进行比较分析。按确诊至终止妊娠时间分为 2组。Ⅰ组 :确诊 4 8h内终止妊娠 ;Ⅱ组 :确诊 4 8h后终止妊娠。对 2组围产期母儿并发症及病死率进行比较分析。结果 :Ⅱ组孕产妇并发DIC、急性肾功能衰竭的发生率及病死率高于Ⅰ组 ;Ⅱ组新生儿窒息的发生率及围产儿病死率高于Ⅰ组。结论 :妊娠期急性脂肪肝发生后 ,终止妊娠最佳时间为确诊后 4 8h内 。

Aim: To explore the clinical features of acute fatty liver of pregnancy (AFLP ) and effects of optimal time of termination of pregnancy on maternal and perinatal prognosis in patients with acute fatty liver. Methods: The clinical findings and outcome of pregnancy of 21 patients with acute fatty liver of pregnancy in recent six years were analyzed. Patients were divided into two groups according to the length from the time diagnosis confirmed to the time of delivery: group Ⅰ (within 48 hours), and groupⅡ(over 48 hours). Complications and maternal and perinatal mortality were analyzed between two groups, respectively. Results: Incidence of DIC, ARF and neonatal asphyxia had significant difference between groupⅠand groupⅡ. Maternal and perinatal mortalities of groupⅠwere significant higher than those of group Ⅱ.Conclusions: The optimal time to end the pregnancy is within 48 hours once diagnosis of AFLP is confirmed.