妊娠合并肝内胆汁淤积症43例临床分析

CLINICAL ANALYSIS ON 43 CASES OF PREGNANCY COMPLICATED WITH INTRAHEPATIC CHOLESTASIS

目的 了解妊娠期肝内胆汁淤积症的特点 ,是妊娠晚期出现皮肤瘙痒及肝内胆汁淤积。血清胆汁酸升高可使胎盘绒毛血管痉挛 ,导致胎儿宫内窘迫、死胎或早产。方法 自 1999年 1月至 2 0 0 0年 4月 ,对我院 43例不同程度的妊娠合并肝内胆汁淤积症进行分析。结果 妊娠合并肝内胆汁淤积症引起皮肤瘙痒起始时间无差异 ,血清胆汁酸值越高 ,产妇黄疸程度越重 ,血清胆汁酸值越高 ,羊水污染率越高。结论 对中重度妊娠合并肝内胆汁淤积症者从住院治疗直至分娩 ,需加强监护 ,若孕龄超过 35周 ,且病情未得到控制 ,可考虑剖宫产。

Objective The study aims at understanding why intrahepatic cholestasis in pregnancy is characterized by the appearance of cutaneous pruritus and intrahepatic cholestasis in the third trimester of pregnancy.The increase of serum bile acid leads to the spasm of placental villous blood vessel,causing fetal distress,dead fetus and premature labor.methods From January 1999 to April 2000,an analysis was made on 43 cases of puerperal women who suffer from pregnancy complicated with intrahepatic cholestasis in varying degrees. Results.No difference exists between pregnancy complicated with intrahepatic cholestasis and cutaneous pruritus in their starting time.Apositive relationship is exhibited not only between serum bile acid and ALT but also between serum bile acid and AST,i.e,the higher the value of serum bile acid is ,the more severe the degree of parturient icterus will be;and the higher the value of serum bile acid is,the higher the rate of meconium staining anmiotic fluid will be.Conclusion Towards the puerperal women who suffer from moderate and/or severe pregnancy complicated with introhepatic cholestasis,a whole course of inpatient treatment and monitor should be offered until childbirth.In cases of pregnant women whose gestational periods are over 35 weeks and whose states of illness are not under control,a cesarean section is preferred to terminate pregnancy.