150例妊娠肝内胆汁淤积症临床分析

Clinical analysis of intrahepatic cholestasis during pregnancy in 150 patients

目的 :探讨妊娠肝内胆汁淤积症 (ICP)对母儿影响及对ICP孕妇进行胎儿监护 (NST)的临床价值。方法 :对 15 0例ICP孕妇的临床表现、生化检查、胎儿电子监护及妊娠结局进行回顾性分析。结果 :孕妇的胆酸、谷丙转氨酶及总胆红素与相应的孕周无线性关系 ;瘙痒出现的孕周与新生儿出生状况及羊水粪染呈明显相关性(P <0 .0 1) ,与产后出血量 ,1min阿普加评分及 5min阿普加评分无明显相关性 ;NST正常者与异常者围生儿不良预后的发生率差异无显著性。结论 :瘙痒出现时间可作为观察ICP病情程度的一项指标。严密监测 ,并综合评价胎儿宫内情况 ,适时终止妊娠 ,以改善围生儿预后。

Objective To explore the effect of intrahepatic cholestasis of pregnancy(ICP) on the mother and fetus,and to assess the clinical value of nonstress test. Methods The symptoms, biochemical examinations, fetal monitoring,and pregnant outcomes of 150 patients with ICP were analyzed retrospectively in our hospital. Results There was no linear relation among serum cholanic acid, glutamic-pyruvic transaminase, total bilirubin, and gestational age when skin pruritus of pregnant women appeared,but there was positive correlation among the neonate status, meconium-stained amniotic fluid, and the onset time of pruritus. There was no correlation between the amount of postpartum hemorrhage and the newborn Apgar scores. No significant difference was found in perinatal prognosis between normal and abnormal outcomes in the nonstress test.Conclusion The appearance of skin pruritus can be a sign of the state of ICP patients. To carefully monitor and comprehensively and continuously estimate the fetal state,and to terminate the pregnancy at proper time are very important to improve the prognosis of perinatal infants.