妊娠肝内胆汁淤积症患者分娩方式及时机的探讨

Appropriate time and way of delivery for women with intrahepatic cholestasis pregnancy

目的:探讨妊娠肝内胆汁淤积症(ICP)患者分娩方式及时机。方法:对本院收治的357例ICP孕妇的一般资料及分娩孕周、分娩方式进行回顾性分析。结果:ICP患者在孕39周后胎儿宫内窘迫发生率明显增高,而孕周在37～38周胎窘发生率相对较低。阴道分娩较剖宫产羊水胎粪污染发生率高。结论:ICP宜在37～38周终止妊娠,分娩方式以剖宫产为宜,阴道试产应严密监护胎儿宫内情况,尤其羊水状况。

[Objective]To discuss appropriate time and way of delivery women with intrahepatic cholestasis pregnancy(ICP). [Method]The thesis retrospectively analyzed the clinical data,gestational weeks of delivery and the way of delivery for 357 pregnant women diagnosed with ICP.[Result]When the patients have been pregnant for more than 39 weeks,the rate of fetal distress was higher compare with those whose gestational weeks were 37 or 38 weeks.Compared with cesarean section,vaginal delivery was more likely to have the meconium staining of the amniotic fluid.[Conclusion]The appropriate delivery time is between 37 or 38 weeks and the appropriate way of delivery is cesarean section.If vaginal delivery is chosen,more attention should be paid to observe the condition of the fetus in the mother's uterus,especially the condition of amniotic fluid.