妊娠期肝内胆汁淤积合并糖尿病孕妇终止妊娠的时机及围产儿结局

The termination of pregnancy in suitable time and effects to the perinatal outcome in gestational diabetes mellitus complicated with intrahepatic cholestasis of pregnancy

目的探讨妊娠期肝内胆汁淤积症（ICP）合并妊娠期糖尿病（GDM）孕妇终止妊娠的时机及围产儿结局。方法对2012年1月-2015年3月住院分娩的160例的ICP合并GDM孕妇临床资料进行回顾性分析,作为ICP＋GDM组,另将同期住院分娩的423例ICP孕妇作为ICP组和402例GDM孕妇作为GDM组,对3组孕妇的分娩围产儿结局进行比较分析。结果与ICP组、GDM组比较,ICP＋GDM组34周前终止妊娠率、新生儿窒息率、II度以上羊水粪染率及小于胎龄儿发生率均明显提高,差异均有统计学意义（均P〈0.05）。结论妊娠肝内胆汁淤积症合并妊娠期糖尿病孕妇分娩围产儿不良结局风险加重,对于此类孕妇,临床上应加强监护,适时终止妊娠,以提高围产儿出生质量。

Objective To explore the termination of pregnancy in suitable time and effects to the perinatal outcome in gestational diabetes mellitus（GDM）complicated with intrahepatic cholestasis of pregnancy（ICP）.Methods 160 pregnant women with ICP and GDM（group ICP and GDM）,423 pregnant women with ICP（group ICP）and 402 pregnant women with GDM（GDM）were involved in the present study.The termination of pregnancy in suitable time and effects to the perinatal outcome of these three groups were analyzed.Results The rate of terminating pregnancy less than34 gestational weeks,the rate of neonatal asphyxia,the rate of amniotic fluid pollution over thanⅡ,the rate of small for gestational age of Group GDM and ICP was higher than that of group GDM and group ICP（P〈0.05）.Conclusion The risk of adverse perinatal outcome increases in gestational diabetes mellitus complicated with intrahepatic cholestasis of pregnancy.In order to improve the perinatal outcome,enhance fetal monitoring and terminate pregnancy in suitable time are very important.