妊娠期肝内胆汁淤积症合并妊娠期糖尿病的母儿结局分析

Clinical Analysis of Perinatal Outcome in Women with Intrahepatic Cholestasis of Pregnancy Combined with Gestational Diabetes Mellitus

目的:探讨妊娠期肝内胆汁淤积症(ICP)合并妊娠期糖尿病(GDM)对母儿结局的影响。方法:选取2012年1月至2013年2月在我院住院分娩的13例ICP合并GDM孕妇为ICP+GDM组,将同期住院分娩的69例单纯ICP孕妇归为ICP组,对两组孕妇的母儿结局进行回顾性比较分析。结果:两组孕妇的子痫前期、胎膜早破、剖宫产、产后出血发生率比较,无明显差异(P>0.05);ICP+GDM组孕妇围产儿Apgar小于7分、新生儿肺炎、早产发生率明显高于ICP组,差异有统计学意义(P均<0.05);ICP+GDM组孕妇围产儿平均出生体重低于ICP组,差异有统计学意义(P<0.05)。结论:妊娠期肝内胆汁淤积症合并妊娠期糖尿病将进一步加重围产儿不良结局,对于此类孕妇,应加强监护和管理,适时终止妊娠,以改善围产儿结局。

Objective： To investigate the effect of （ICP） combined with gestational diabetes mellitus （GDM） on perinatal outcome in intrahepatic cholestasis of pregnancy. Methods： 13 cases of ICP combined with GDM delivered in our hospital from January 2012 to February 2013 were selected as the ICP＋GDM group, while another 69 cases oflCP were selected as the ICP group, then a retrospective analysis was conducted about the perinatal outcome between the two groups. Results There was no significant difference about the incidence of preeclampsia, premature rupture of membrane, cesarean section and postpartum hemorrhage between the two groups（P〉0. 05）. The rate of Apgar was lower than 7, neonatal pneumonia and preterm delivery in ICP＋GDM group was significantly higher than that of the ICP group （P〈0.05）. Besides, the average fetal birth weight in ICP＋GDM group was lower than that of the ICP group, and there was statistically significant difference between the two groups （P〈0.05）. Conclusions： The risk of adverse perinatal outcome increased in intrahepatic cholestasis of pregnancy combined with gestational diabetes mellitus. To improve the perinatal outcome, we should enhance the monitoring and management oflCP women combined with GDM. In addition, the termination of pregnancy in a suitable time is also important.