You Position: Home > Paper
Perinatal outcomes of intrahepatic cholestasis of pregnancy: analysis of 1210 cases
( views:505, downloads:317 )
- Author:
- No author available
- Journal Title:
- NATIONAL MEDICAL JOURNAL OF CHINA
- Issue:
- 7
- DOI:
- 10.3760/j:issn:0376-2491.2006.07.005
- Key Word:
- 胆汁郁积,肝内;妊娠结局;妊娠并发症
Abstract： 目的探讨妊娠肝内胆汁淤积症(ICP)的围生结局.方法对近10年在我院产前检查并住院治疗分娩的1210例ICP病例资料进行回顾性分析.结果 ICP先兆早产率19.0%(230/1210),88.7%(204/230)发生于32周后,先兆早产住院病例发生死胎占所有ICP死胎的46.7%(7/15);ICP早产率24.0%(290/1210),96.2%(279/290)分布于34周以后,89.7%(260/290)为胎儿异常行剖宫产;羊水胎粪污染率23.2%(281/1210),41.3%(116/281)发生于临产前,羊水胎粪污染对新生儿窒息(新生儿1 min Apgar评分≤7分)预测率为25%(70/281);新生儿窒息发生率7.1%(86/1210);围生儿病死率22.5‰(27/1210),其中死胎占56%(15/27),死胎平均孕周36.5周±1.2周,80%(12/15)发生于妊娠35周后,所作胎心监护均无异常发现,95%(19/20)的死胎、死产突然发生于先兆早产、偶然宫缩或临产初期;剖宫产率85.9%(1039/1210),胎儿生长受限(FGR) 发生率0.9%(11/1210),产后出血率1.4%(17/1210),8.1%(101/1210)ICP患者合并子痫前期.结论ICP胎儿无明显FGR表现,子痫前期及产后出血发生率与一般孕妇人群相似;常规胎儿监护手段难以预测ICP死胎;积极防治先兆早产,重视先兆早产、偶然宫缩、产前羊水胎粪污染或临产初期时的胎儿监护,把握终止妊娠时机(34～37周),是降低ICP围生儿病死率的重要手段.
- [1]王晓东,刘淑芸,衡正昌.妊娠肝内胆汁淤积症胎儿宫内缺氧机理的初步探讨[J].1998,(2).
- [2]戴钟英.妊娠期肝内胆汁淤积症时终止妊娠的时机选择[J].2002,(1).
- [3]中华医学杂志编委会,诸骏仁,庄依亮,等.妊娠合并内科疾病专题座谈会纪要[J].1986,(5).
- [4]曹泽毅主编.中华妇产科学[M].1999.
- [5]R, Reid,K J, Ivey,R H, Rencoret,etc.Fetal complications of obstetric cholestasis.[J].1976,1(6014).
- [6]H, Reyes.The spectrum of liver and gastrointestinal disease seen in cholestasis of pregnancy.[J].1992,21.
- [7]G. A. Campos,F. A. Guerra,E. J. Israel.Effects of Cholic Acid Infusion in Fetal Lambs[J].1986,65(1).
- [8]W H, Sepúlveda,C, González,M A, Cruz,etc.Vasoconstrictive effect of bile acids on isolated human placental chorionic veins.[J].1991,42.
- [9]A J, Rioseco,M B, Ivankovic,A, Manzur,etc.Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome.[J].1994,170(3).