重度妊娠期肝内胆汁淤积症对母婴结局影响的临床分析

Clinical Analysis of the Impact of Severe Intrahepatic Cholestasis of Pregnancy on Maternal and Neonatal Outcomes

目的:分析重度妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)对母婴结局的影响,以提高对ICP的认识与治疗水平。方法:选择ICP产妇58例,根据ICP分度标准分为轻度组(n=26例)和重度组(n=32例),比较两组产妇的母婴结局。结果:与轻度组相比,重度组产妇剖宫产率、产后出血与平均产后出血量显著升高或增加,阴道分娩率显著降低,组间比较差异均具有统计学意义(P<0.05);重度组新生儿早产、胎儿窘迫、羊水污染和新生儿窒息的发生率均显著上升,新生儿平均出生体重显著降低,组间比较差异均具有统计学意义(P<0.05)。结论:ICP对产妇及新生儿均有不良影响,对ICP严重程度进行划分,有利于临床处理。对于重度ICP产妇,应尽早采取剖宫产分娩的方式终止妊娠。

Objective： To analyze the influence of severe intrahepatic cholestasis of pregnancy（ICP） on the maternal and neonatal outcomes and improve understanding and treatment of ICP. Methods： 58 cases of ICP gravida were collected and divided into the mild group（n=26 patients） and severe group（n=32 cases） according to the ICP indexing standards, the maternal and neonatal outcomes were compared between two groups. Results： Compared with the mild group, the rate of cesarean section, postpartum hemorrhage and average amount of postpartum hemorrhage of severe group were significantly enhanced or increased（P0.05）, while a significant reduction in vaginal delivery was observed（P0.05）; the incidence rates of newborn premature birth, fetal distress, sheep water pollution and neonatal asphyxia of severe group were significantly rised（P0.05）, a significant reduction in the average birth weight of newborns was found in the severe group（P0.05）. Conclusion： ICP had adverse effect on both maternal and neonatal, dividing the severity of the ICP was conducive to the clinical treatment of ICP. For the severe ICP, maternal cesarean delivery should be taken as soon as possible to end pregnancy.