152例亚临床妊娠期肝内胆汁淤积症患者的围生结局分析

Analysis on perinatal outcome of 152 patients with subclinical intrahepatic cholestasis of pregnancy

目的:探讨亚临床妊娠期肝内胆汁淤积症(ICP)对围生结局的影响。方法:选择152例孕期有皮肤瘙痒、而肝功能和胆汁酸正常的亚临床ICP孕妇为研究组,对照组为152例无皮肤瘙痒、年龄和产次匹配的正常产妇,比较两组的围生结局。结果:研究组的产后出血发生率、羊水Ⅱ°～Ⅲ°污染发生率和产时胎监异常发生率分别为11.18%、20.39%和15.13%,明显高于对照组的1.98%、7.89%和4.61%(P<0.05)。两组的孕周、剖宫产率、阴道助产率、早产发生率和新生儿窒息发生率差异无统计学意义(P>0.05)。两组均无死胎、死产和新生儿死亡发生。结论:皮肤瘙痒、而肝功能和胆汁酸正常的亚临床ICP对产妇和新生儿的围生结局有一定程度的影响,临床上应提高警惕。

Objective： To explore the effect of subclinical intrahepatic cholestasis of pregnancy （ICP） on perinatal outcome. Methods： A total of 152 subclinical ICP pregnant women with skin itch, normal liver function and bile acid levels were selected as study group; 152 normal pregnant women without skin itch were selected as control group, the age and parities of pregnant women in the two groups were matched; the perinatal outcomes in the two groups were compared. Results： The incidences of postpartum hemorrhage, amniotic fluid contamination of grade Ⅱ～Ⅲ, and intrapartum abnormality during fetal monitoring in study group were 11.18% , 20. 39% , and 15.13%, respectively, which were statistically significantly higher than those in control group （1.98%, 7.89%, and 4. 61%, respectively） （ P 〈 0. 05 ） . There was statistically significant difference in the gestational weeks, cesarean section rate, vaginal midwifery rate, the incidences of premature delivery and neonatal asphyxia between the two groups （P 〉 0. 05） . No stillbirth, fetal death, and neonatal death occurred. Conclusion： Subclinical ICP combined with skin itch, normal liver function and bile acid levels have certain impacts on perinatal outcomes of parturient women and neonates, which should be alerted in clinic.