妊娠期肝内胆汁淤积症脐血流比值对围产儿预后的影响

The effect of intrahepatic cholestasis of pregnancy umbilical blood flow ratio on the perinatal prognosis

目的探讨妊娠期肝内胆汁淤积症(ICP)脐血流比值对新生儿预后的影响。方法观察32例ICP孕妇的肝功能(TBA、ALT、AST),围产儿结局(孕周、新生儿体重,胎儿窘迫、新生儿窒息、羊水胎粪污染、新生儿吸入性肺炎和早产)和脐血流比值对围产儿预后等情况,并与同期分娩32例正常孕妇进行比较分析。结果 (1)ICP组TBA、ALT、AST水平均高于对照组(P<0.01);(2)ICP组胎儿孕周、体重均低于对照组(P<0.05或P<0.01);ICP组胎儿窘迫、新生儿窒息、羊水胎粪污染、新生儿吸入性肺炎和早产的发生率高于对照组(P<0.05或P<0.01);(3)ICP组RI值、S/D值高于对照组(P<0.01),两组PI值差异无显著性(P>0.05)。结论对ICP孕妇早期和定期进行脐动脉血流的测定,有助于加强对ICP孕妇的监测,有助于及早地发现ICP孕妇胎儿宫内不良状态,有利于改善新生儿结局。

Objective： To investigate The effect of intrahepatic cholestasis of pregnancy umbilical blood flow ratio on the perinatal prognosis.Methods：The liver function（TBA,ALT and AST）,perinatal（gestational age,birth weight,fetal distress,neonatal asphyxia,meconium stained amniotic fluid,neonatal aspiration pneumonia,premature birth） and umbilical perfusion ratio perinatal prognosis of 32 cases ICP pregnant women were observed,and compared with 32 cases of the same period in childbirth normal pregnant women.Results：（1） TBA,ALT,and AST levels of ICP group were higher than control group（P0.01）;（2） Fetal gestational age and body weight were lower ICP group than the control group（P0.05 or P0.01）;fetal distress,neonatal asphyxia,meconium stained amniotic fluid,neonatal aspiration pneumonia and incidence of preterm birth of ICP group were higher than control group（P0.05 or P0.01）;（3） RI,S / D value of ICP group were significantly higher than control group（P0.01）,PI values of two groups had no significant difference（P0.05）.Conclusion： The ICP pregnant early and regular of umbilical artery blood flow measurement,contribute to strengthen the monitoring of pregnant women with ICP,contribute to the early discovery of ICP in maternal fetal adverse state,is conducive to the improvement of neonatal outcomes.