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目的通过对12例妊娠期肝内胆汁淤积症致死胎的临床分析,探讨减低胎儿窘迫、胎死宫内的预防措施。方法回顾分析1998年1月-2008年1月在舒城县人民医院收治的妊娠期肝内胆汁淤积症死胎的12例病例资料,死胎均发生于妊娠晚期,且死胎发生前无明显的胎动减少或胎儿监护异常。抽取羊水均有胎粪污染。结果12例死胎入院后抽取羊水均有胎粪污染,均经阴道平产分娩,外观无畸形,胎盘、胎膜均黄染。结论妊娠期肝内胆汁淤积症易突发胎儿窘迫,死胎难以预测。胎粪出现可能是胎儿预后不良最敏感的指标。
Objective To analyze the clinical analysis of 12 cases of fetal death caused by intrahepatic cholestasis of pregnancy and to discuss the preventive measures to reduce fetal distress and intrauterine fetal death. Methods The data of 12 cases of stillbirth during intrahepatic cholestasis of pregnancy admitted to Shucheng People’s Hospital from January 1998 to January 2008 were retrospectively analyzed. The stillbirths occurred in the third trimester of pregnancy and there was no obvious decrease in fetal movement before the stillbirth Or abnormal fetal care. Amniotic fluid extraction have meconium contamination. Results Twelve cases of stillbirth after admission were amniotic fluid were stained meconium-stained, all by vaginal delivery, the appearance of deformity, placenta, fetal membranes were yellow dye. Conclusion Intrahepatic cholestasis of pregnancy is prone to fetal distress and fetal death is difficult to predict. Meconium may be the most sensitive indicator of poor fetal prognosis.