妊娠肝内胆汁淤积症终止妊娠时机与围生儿结局

Pregnancy termination timing for pregnant intrahepatic cholestasis patients and perinatal outcomes of peinatals

目的探讨妊娠肝内胆汁淤积症终止妊娠的时机。方法对我院收治的妊娠肝内胆汁淤积症52例进行回顾性分析,将择期剖宫产终止妊娠者36例设为A组与自然临产或因胎儿宫内窘迫行剖宫产设为B组作对比分析。结果52例病例中血清胆汁酸水平越高其羊水污染率越高(P≤0.01);A组与B组间围生儿死亡率为2.7%与6.2%(≤0.05),早产率为36.1%与12.5%(≤0.05),新生儿窒息率为19.4%与43.7%(≤0.05)。结论妊娠肝内胆汁淤积症适时终止妊娠可降低围生儿死亡率及新生儿窒息率,但增加早产率。

Objective To discuss pregnancy termination timing for pregnant intrahepatic cholestasis patients. Methods Retrospective analysis was held on 52 pregnant intrahepatic cholestasis patients who were admitted to our hospital. Two groups were divided, Group A with 36 selective cesarean section patients while group B with natural birth or cesarean section patients for fetal intrauterine distress. Compared and analyed the data between two groups. Results In all cases amniotic fluid contamination rates were paraUel to serum bile acid levels （P≤0.01）. Mortality rates of group A and group B were 2.7% and 6.2%（P≤0.05）, premature birth rates were 36.1% and 12.5% （P≤0.05） and neonatal asphysia rates 19.4% and 43.7% （P≤0.05） respectively. Conclusion Timely termination of pregnancy for pregnant intrahepatic cholestasis patients can decrease perinatal mortality and neonatal asphysia rates while increasing premature birth rate.