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目的探讨妊娠期肝内胆汁淤积症(ICP)对妊娠结局的影响以及早诊断、早治疗的意义。方法回顾性分析2008年3月~2013年3月在镇江市妇幼保健院分娩的ICP患者90例,其中进行系统产前检查及治疗的62例为治疗组,未进行系统产前检查或入院时已临产而未能接受综合治疗的28例为未治疗组,比较两组分娩情况及围生儿结局。结果治疗组与未治疗组早产、胎儿窘迫、羊水粪染、新生儿窒息、剖宫产、产后出血发生率比较差异有统计学意义(P<0.05);治疗组总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)及天门冬酸氨基转移酶(AST)水平显著低于未治疗组(P<0.05)。结论 ICP对围生儿的危害极大。加强孕期监护,早诊断、早治疗以及适时终止妊娠能有效降低ICP患者的妊娠风险,改善母婴结局。
Objective To investigate the effect of intrahepatic cholestasis of pregnancy (ICP) on pregnancy outcomes and the significance of early diagnosis and early treatment. Methods Ninety patients with ICP who gave birth in Zhenjiang MCH hospital from March 2008 to March 2013 were retrospectively analyzed. Of the 62 patients who underwent systematic prenatal examination and treatment, 62 patients were treated without systematic prenatal examination or admission 28 cases who had been on labor and failed to receive comprehensive treatment were untreated group. The delivery status and perinatal outcome were compared between the two groups. Results The incidence of preterm birth, fetal distress, meconium-stained amniotic fluid, neonatal asphyxia, cesarean section and postpartum hemorrhage in treatment group and untreated group were significantly different (P <0.05). The total bile acid (TBA) The levels of ALT and AST were significantly lower than those of the untreated group (P <0.05). Conclusion ICP is very harmful to perinatal children. Strengthen the monitoring of pregnancy, early diagnosis, early treatment and timely termination of pregnancy can effectively reduce the risk of pregnancy in patients with ICP, improve maternal and infant outcomes.