妊娠急性脂肪肝10例妊娠结局分析

Clinical Analysis of 10 Cases with Acute Fatty Liver of Pregnancy

目的探讨妊娠急性脂肪肝终止妊娠的时机及方式对妊娠结局的影响。方法收集2004年1月至2015年4月湖北省荆州市中心医院10例妊娠急性脂肪肝资料,对急性脂肪肝患者的临床表现、分娩方式和转归进行回顾性分析。结果 10例妊娠急性脂肪肝患者,经阴道分娩4例,孕产妇死亡3例(75%),胎死宫内1例(25%),新生儿死亡3例(1例为双胎)(75%),剖宫产6例,孕产妇死亡1例(16.7%),新生儿无死亡。起病至分娩平均为7.5 d,产妇死亡者起病时间2例为12 d,1例为14 d,1例为15 d,孕产妇存活者均为7 d以内。结论妊娠急性脂肪肝剖宫产母儿病死率明显低于阴道分娩,应早诊断,早治疗,尽快终止妊娠,是防止妊娠急性脂肪肝患者病情进一步加重,降低母儿病死率的关键。

Objective To investigate the influence on the AFLP pregnancy outcome of the timing and way on the termination. Methods Collect clinical data in Jingzhou center hospital from January 2004 to April 2015, the clinical manifestations, delivery way and outcome were analyzed retrospectively. Result In the cases of vaginal delivery, three maternal death（75%）, one intrauterine death（25%）, three neonatal death（75%）, in the cesarean delivery cases, one maternal death（16.7%）, no neonatal death. To the onset of the average delivery time is 7.5 days, in the maternal death cases, twelve days in two cases, fourteen in one case, fifteen in one case, in the maternal survivor cases, all within seven days. Conclusion Maternal mortality and newborn rate in cesarean delivery cases was lower than that in vaginal delivery cases, timely diagnosis and treatment, termination of pregnancy as soon as possible is the key of prevent illness and reduction the morbidity of gravida and fetus in perinatal.