妊娠合并重型肝炎的产科特点分析

Analysis of features of pregnants complicated with hepatitis gravis

目的探讨妊娠合并重型肝炎的产科特点,指导产科处理。方法回顾分析40例妊娠合并重型肝炎病例,总结其产科特点,并随机选择同期无合并症、并发症的孕妇60例作为对照组(本文欲比较的并发症除外),对比各种并发症的发生情况。统计方法采用卡方检验和t检验。结果妊娠合并重型肝炎多数在孕晚期发病75.0%(30/40);产前出血20.0%(8/40);妊娠高血压疾病27.5%(11/40);急产20.0%(8/40);宫缩乏力66.7%(12/18);产后出血88.6%(31/35);胎儿窘迫50.0%(20/40);死胎17.5%(7/40);早产、流产65.0%(26/40);围产儿死亡率20.0%(6/30),窒息率43.3%(13/30)。以上并发症与对照组比较均有显著性差异。结论妊娠合并重型肝炎常于孕晚期发病,易并发产前出血、妊娠高血压疾病、急产、宫缩乏力、产后出血、产褥感染、胎儿窘迫、死胎、早产、流产、新生儿窒息甚至死亡。

Objective To explore the features of pregnants compliated with hepatitis gravis for guiding obstetric treatment. Methods There 40 pregnant hepatitis gravis cases were retrospectively analyzed. Another 60 pregnant women without complications were chosen randomly as control group. The results were statistically analyzed. Results Most of pregnant hepatitis gravis paptients were at the third trimester of pregnancy accounted of 75% （30/40） ; the incidence of complications were as followings： antenatal hemorrhage 20% （8/40）, pregnancy- induced hypertension 27.5% （11/40）, partus precipitatus 20% （8/40）, uterine inertia66.7% （12/18）, postpartum hemorrhage 88.6% （31/35）, fetal distress 50% （20/40）, fetal death 17.5% （7/40）, premature delivery or abortion 65% （26/40）, mortality of perinatal infant 2 0.0%（6/30）, asphyxia of perinatal infant 43.3%（13/ 30） .There was significant difference between the two groups in all the complications mentioned above. Conclusion The gestational hepatitis gravis occurred to most of the patients at the third trimester resulting in a series of complications. Thus attention be paid to the obstetric features of gestafional hepatitis for taking effective measurs.