妊娠期肝内胆汁淤积症早期干预措施及对围生儿的影响

Intrahepatic cholestasis of pregnancy characteristics and clinical prognosis of perinatal child

目的探讨妊娠期肝内胆汁淤积症(ICP)患者的临床特点、终止妊娠方式的选择及对围生儿预后的影响。方法选择2008年3月—2011年3月分娩的100例妊娠期肝内胆汁淤积症患者作为观察组,同期选取住院分娩的正常孕妇120例作为对照组,比较两组孕妇及新生儿情况以及观察组中分娩方式不同对新生儿的影响。结果两组的早产、胎儿宫内窘迫、死亡及羊水污染明显高于对照组(P<0.05);观察组孕妇血清总胆汁酸值不同对新生儿的影响亦不同。结论妊娠期肝内胆汁淤积症对母婴,特别是新生儿的危害极大,导致早产、胎儿宫内窘迫、胎死宫内、产后出血等并发症,增加了围生儿发病率和死亡率。因此应加强孕妇的健康教育,高度重视产前检查和中期妊娠胆汁酸的监测,做到早发现、早治疗,对减少母婴并发症有重要作用。

Objective To investigate the clinical features of intrahepatic cholestasis of pregnancy（ICP） in patients,mode of selection and termination of pregnancy on perinatal outcome of children.Methods March 2008-March 2011 in our hospital delivery of 100 cases patients with intrahepatic cholestasis of pregnancy as the observation group,selected hospital delivery over the same period 120 cases of normal pregnant women as the control group,the two groups of pregnant women and newborn as well as the observation group in the different mode of delivery on neonatal effects.Results The observation groups of premature delivery,fetal distress,death and amniotic significantly higher than those of the control group（P0.05）;Observation group maternal serum total bile acid have different effects on different newborn.Conclusions Intrahepatic cholestasis of pregnancy on maternal,newborn,especially the great harm,leading to premature delivery,fetal distress,fetal death,postpartum hemorrhage and other complications,increased perinatal incidence and mortality.Pregnant women should be strengthened health education,attach great importance to the mid-pregnancy,prenatal care and monitoring of bile acids,so early detection and early treatment have an important role to reduce maternal and neonatal complications.