慢性丙型肝炎病毒携带对妊娠结局的影响

Effect of chronic hepatitis C virus infection on pregnancy outcome

目的通过比较慢性丙型肝炎病毒(HCV)感染携带的孕妇、慢性乙型肝炎病毒(HBV)感染携带的孕妇及正常孕妇在妊娠期的临床特点,探索慢性HCV携带孕妇的妊娠结局。方法选取2017年1月至2020年1月首都医科大学附属北京佑安医院收治的50例妊娠期合并慢性HCV携带孕妇作为研究对象(HCV携带组)。另选取同期住院治疗的50例慢性HBV携带孕妇(HBV携带组)及50例正常孕妇(对照组)。比较三组的基线资料及妊娠结局。结果①三组年龄、分娩孕周及分娩方式比较,差异无统计学意义(P>0.05)。②HCV携带组与HBV携带组母体并发症发生率比较,差异无统计学意义(P>0.05);HCV携带组母体并发症发生率高于对照组,且两组妊娠期肝内胆汁淤积症及产后出血发生率比较,差异具有统计学意义(P<0.05)。③三组新生儿窒息及小于胎龄儿发生率比较,差异无统计学意义(P>0.05)。结论HCV携带可导致不良母体并发症,临床上应高度重视,密切监护,严密监测胎儿宫内状况,早期诊断积极治疗,对症处理,以便减少不良妊娠结局。

Objective To compare the clinical characteristics of pregnant women with chronic hepatitis C virus(HCV)infection,pregnant women with chronic hepatitis B virus(HBV)infection and normal pregnant women during pregnancy,and to explore the pregnancy outcome of pregnant women with chronic HCV infection.Methods 50 pregnant women with chronic HCV admitted to Beijing You'an Hospital of Capital Medical University from January 2017 to January 2020 were selected as HCV group,another 50 cases with chronic HBV as HBV group and 50 cases of normal pregnant women as control group.Baseline data and pregnancy outcomes of the three groups were compared.Results①There were no significant differences in age,gestational age and delivery mode among the three groups(P>0.05).②There was no significant difference in the incidence of maternal complications between HCV group and HBV group(P>0.05).The incidence of maternal complications in the HCV group was higher than that in the control group,and the incidence of intrahepatic cholestasis during pregnancy and postpartum hemorrhage was significantly different between the two groups(P<0.05).③There was no significant difference in the incidence of neonatal asphyxia,smaller for gestational age and neonatal death among the three groups(P>0.05).Conclusions Pregnant women with HCV can lead to adverse maternal complications.It should be paid great attention and closely monitored.The fetal intrauterine conditions was strictly monitored too.Early diagnosis,active treatment and symptomatic treatment can reduce adverse pregnancy outcomes.