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目的探讨妊娠肝内胆汁淤积症(ICP)对母婴的影响及处理方式。方法回顾性分析52例妊娠肝内胆汁淤积症患者的母婴结局及治疗方式。结果 ICP患者产后出血、胎儿宫内窘迫、羊水污染及新生儿窒息的发生率明显高于对照组,两组比较早产率差异无统计学意义(P>0.05)。上述各指标除早产外,其发生率均与血清胆汁酸水平呈正相关,且血清胆汁酸水平越高,孕妇出现瘙痒症状时间越早,其差异有统计学意义(P<0.05)。结论 ICP严重影响胎儿健康,产前定期监测血清胆汁酸水平有助于判断胎儿预后,对于出现黄疸者更应加强产前监护,适时终止妊娠,以减少母婴并发症,改善妊娠结局。
Objective To investigate the effect of intrahepatic cholestasis of pregnancy (ICP) on maternal and infant and its treatment. Methods Retrospective analysis of 52 cases of pregnancy induced intrahepatic cholestasis of maternal and infant outcomes and treatment. Results The incidence of postpartum hemorrhage, fetal distress, amniotic fluid contamination and neonatal asphyxia in ICP patients were significantly higher than those in control group. There was no significant difference in preterm birth rate between the two groups (P> 0.05). Except for preterm birth, the above indexes were positively correlated with serum bile acid level, and the higher serum bile acid level, the earlier the pruritus symptom occurred in pregnant women, the difference was statistically significant (P <0.05). Conclusion ICP seriously affects fetal health. Regular monitoring of serum bile acid level during prenatal period will help to determine the prognosis of fetus. For patients with jaundice, prenatal care should be strengthened and pregnancy terminated in time to reduce maternal and infant complications and improve pregnancy outcomes.