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目的探讨妊娠期肝内胆汁淤积症(ICP)的病情严重程度和围生儿预后的相关性。方法回顾性分析2008年1月至2013年12月住院分娩的产科ICP孕妇300例,分析轻、重度ICP患者围生儿的预后结局,同时选择同期住院的正常孕妇300例作为对照。结果正常对照组终止妊娠的孕周为(39.2±1.9)周,轻度ICP组(37.4±1.6)周,重度ICP(35.1±1.2)周,三组间比较差异有统计学意义(P<0.05);正常组、轻度ICP组、重度ICP组的胎儿窘迫率分别为2.0%、14.1%、38.0%,新生儿窒息率分别为1.0%、6.7%、17.5%,早产率分别为3.7%、14.7%、80.3%,低体重儿率分别为2.0%、11.7%、21.9%,三组间各围生儿结局差异均有统计学意义(P均<0.01)。结论 ICP的病情严重程度与围生儿的预后密切相关,应密切监测重度ICP患者,适时终止妊娠,改善围生儿预后。
Objective To investigate the relationship between the severity of intrahepatic cholestasis of pregnancy (ICP) and the prognosis of perinatal children. Methods A retrospective analysis of 300 obstetric ICP pregnant women hospitalized from January 2008 to December 2013 was performed. The prognosis of perinatal children with mild and severe ICP was analyzed. 300 normal pregnant women who were hospitalized in the same period were selected as controls. Results The gestational age of the termination group was (39.2 ± 1.9) weeks in the normal control group, 37.4 ± 1.6 weeks in the mild ICP group and 35.1 ± 1.2 weeks in the severe ICP group (P <0.05) ). Fetal distress rates of normal group, mild ICP group and severe ICP group were 2.0%, 14.1% and 38.0% respectively. Neonatal asphyxia rates were 1.0%, 6.7% and 17.5% respectively. Premature birth rates were 3.7% 14.7% and 80.3% respectively. The rates of low birth weight were 2.0%, 11.7% and 21.9%, respectively. There was significant difference in all three neonatal outcomes between the three groups (all P <0.01). Conclusion The severity of ICP is closely related to the prognosis of perinatal children. Patients with severe ICP should be closely monitored, pregnancy should be terminated timely, and the prognosis of perinatal children should be improved.