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目的研究妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者的分娩方式及妊娠结局。方法选取152例ICP孕妇为研究对象,分为轻度组83例,重度组69例;随机抽取80例同期经阴道分娩的正常孕妇为对照组,比较妊娠结局。结果经阴道分娩产妇胎儿窘迫、新生儿窒息及围生儿死亡发生率重度ICP组高于轻度ICP组和对照组(P<0.05);轻度ICP组与对照组围生儿不良结局比较,差异无统计学意义(P>0.05)。轻度ICP组阴道分娩与剖宫产分娩者比较,羊水粪染及新生儿窒息率差异无统计学意义(P>0.05),剖宫产产妇产后出血率高于阴道分娩产妇(P<0.05)。结论轻度ICP患者可适当延长孕周,待产程发作后严密监测下经阴道试产,重度ICP适时剖宫产终止妊娠。
Objective To study the mode of delivery and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy (ICP). Methods A total of 152 pregnant women with ICP were enrolled in this study. They were divided into mild group (n = 83) and severe group (n = 69). Eighty pregnant women with vaginal delivery at the same period were selected as the control group, and the pregnancy outcome was compared. Results The incidence of fetal distress, neonatal asphyxia and perinatal death in vaginal delivery was significantly higher in ICP group than in mild ICP group and control group (P <0.05). Compared with control group, The difference was not statistically significant (P> 0.05). There was no significant difference between mild ICP group and cesarean section in childbirth (P> 0.05). The rate of postpartum hemorrhage in cesarean section was higher than that in vaginal delivery (P <0.05) . Conclusions Mild ICP patients may be extended gestational age, to be closely monitored by the vaginal trial after the onset of labor, severe cesarean section termination of pregnancy at the right time.