妊娠胆汁淤积症175例临床分析

Clinical Analysis on 175 Cases of Intrahepatic Cholestasis of Pregnancy

目的探讨妊娠期肝内胆汁淤积症(ICP)对围产期影响及其防治对策。方法2001年1月—2006年12月在我院分娩的ICP孕妇175例与同期正常孕妇2 957例作回顾性分析。结果175例ICP中发生早产31例,早产发生率为17.71%;死胎3例,新生儿死亡2例,其围产儿死亡率为28.57‰;新生儿Apgar评分≤7分≥4分者8例,占4.57%;产后出血5例,占2.86%。早产率较正常组高(P<0.01),新生儿窒息率高(P<0.05),羊水粪染率高(P<0.005),产后出血量多(P<0.01)。结论ICP可引起早产,胎儿宫内窘迫及新生儿窒息,增高了剖宫产率及产后出血量,加强产前监护,早期诊断,产时严密观察产程进展、胎心变化、羊水情况,适时终止妊娠,是降低ICP并发症的有效措施。

Objective To explore the influence of intrahepatic cholestasis of pregnancy （ICP） in perinatal period and its prevention. Methods A total of 175 pregnant women with ICP （ICP group） , who delivered in the hospital between Jan. 2001 and Dec. 2006, were retrospectively analyzed, and 2957 normal pregnant women were enrolled into the study as controls （control group）. Results Among. the 175 ones with ICP, there were 31 who delivered prematurely （ 17.71% ） , three who gave birth to dead fetus, and two whose babies died as newborns. The perinatal death rate was 28.57%v. Furthermore, there were eight ones with an Apgar Score of 4 -7 （4.57%） , and five with a postpartum hemorrhage （2.86%）. As for the comparison between the two groups, the ICP group possessed a significant increase in premature delivery rate （ P 〈 0.01 ） , newborn asphyxiation rate （ P 〈 0.05 ） , amniotic fluid feces contamination rate （ P 〈 0. 005 ） and postpartum hemorrhage volume （ P 〈 0.01 ）. Conclusion ICP may lead to premature delivery, fetal intrauterine embarrassment and newborn asphyxiation. The pregnant women with ICP are apt to be performed Caesarean operation and suffer from postpartum hemorrhage. Antepartum care takes an important role for the pregnant women with ICP.