妊娠期肝内胆汁淤积症临床特点与妊娠结局

Clinical Characteristics and Pregnancy Outcome of Intrahepatic Cholest asis of Pregnancy

目的探讨妊娠期肝内胆汁淤积症的临床特点与妊娠结局和相应的防治措施。方法选取于2016年3月—2017年3月期间在该院进行分娩的ICP产妇共计180例为观察组,随机抽取同期于该院进行分娩的正常产妇180例为对照组,观察指标为妊娠结局和围产期中的并发症。结果观察组产妇的妊娠期高血压发生率为18.89%,对照组为7.22%;观察组胎膜早破的发生率为13.89%,对照组为6.11%;早产并发症发生率为10.00%,对照组为2.78%。观察组产妇的妊娠期高血压、胎膜早破、早产并发症的发生率明显均高于对照组,差异均有统计学意义(χ~2=5.32、6.45、13.24,P<0.05)。观察组产妇的剖宫产率为85.58%,羊水污染率为40.56%、产后出血率为9.44%、胎儿窘迫发生率为13.89%,相对应的对照组的分别为37.22%、12.22%、3.33%、5.56%,观察组产妇的剖宫产率、羊水污染率、产后出血率、胎儿窘迫发生率均明显高于对照组,差异均有统计学意义(χ~2=55.32、21.23、3.98、4.52,P<0.05);观察组的新生儿窒息率7.22%与对照组的6.11%相近,差异无统计学意义(χ~2=1.32,P>0.05)。结论ICP的危险性高,临床上应定时监测ICP产妇的TBA水平,及时进行科学合理的防治,才能改善其不良预后,改善妊娠结局。

Objective To investigate the clinical features, pregnancy outcomes and corresponding prevention and treatment measures of intrahepatic cholestasis during pregnancy. Methods A total of 180 ICP maternity women who were delivered in the hospital during March 2016 to March 2017 were selected as the observation group. 180 normal women who were delivered in the hospital for the same period were randomly selected as the control group. Observe index was pregnancy, outcomes and perinatal complications. Results The incidence of gestational hypertension in the observation group was 18.89% and that in the control group was 7.22%. The incidence of premature rupture of membranes was 13.89% in the observation group and 6.11% in the control group; the incidence of complications in the preterm delivery was 10.00%. The control group was 2.78%. The incidence of complications of gestational hypertension, premature rupture of membranes, and premature delivery in the observation group was significantly higher than that in the control group, and the difference was statistically significant （χ^2=5.32, 6.45, 13.24, P〈0.05）. The cesarean section rate of the observation group was 85.58%, the amniotic fluid contamination rate was 40.56%, the postpartum hemorrhage rate was 9.44%, and the incidence of fetal distress was 13.89%. The corresponding control group was 37.22%, 12.22%, and 3.33%, 5.56% respectively, the cesarean section rate, amniotic fluid contamination rate, postpartum hemorrhage rate, and fetal distress rate of the observation group were significantly higher than the control group, and the differences were statistically significant （χ^2=55.32, 21.23, 3.98, 4.52, P〈0.05）; The neonatal asphyxia rate in the observation group was 7.22% similar to 6.11% in the control group, and the difference was not statistically significant （χ^2=1.32, P〉0.05）. Conclusion The risk of ICP is high. Clinically, the TBA level of ICP maternal should be monitored regularly, and scientific and reasonable prevention and treatment should be conducted in time to improve its poor prognosis and improve pregnancy outcome.