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目的探讨妊娠期肝内胆汁淤积症(ICP)孕妇肝功能指标与围生儿预后的关系。方法对166例ICP孕妇肝功能指标及围生儿预后进行回顾性分析。结果孕妇血清转氨酶(ALT,AST)及胆红素(B IL)水平升高者胎儿窘迫及羊水粪染发生率增加,新生儿体重及Apgar评分与胆红素水平有关,通过公式计算可以预测围生儿预后。孕妇胆汁酸(TBA)升高程度与羊水粪染及胎儿窘迫率无关,其它肝功能指标,脐动脉S/D比值及瘙痒时间的长短也与胎儿预后无关。结论ICP孕妇转氨酶及胆红素水平升高者胎儿预后不佳,必须高度重视,适时剖宫产终止妊娠将明显改善围生儿预后。
Objective To investigate the relationship between the indexes of liver function in pregnant women with intrahepatic cholestasis of pregnancy (ICP) and the prognosis of perinatal children. Methods Retrospective analysis was performed on the indexes of liver function and the prognosis of perinatal children in 166 pregnant women with ICP. Results Pregnant women with elevated levels of serum transaminase (ALT, AST) and bilirubin (BIL) were associated with fetal distress and increased meconium-stained amniotic fluid. Neonatal weight and Apgar scores were correlated with bilirubin levels. Childhood prognosis. The increase of bile acid (TBA) in pregnant women has nothing to do with the rate of amniotic fluid meconium and fetal distress. The other indexes of liver function, the ratio of S / D of umbilical artery and the time of pruritus are also unrelated to the prognosis of fetus. Conclusion ICP pregnant women with elevated levels of aminotransferases and bilirubin have poor prognosis and must be given high priority. Cesarean section termination of pregnancy will significantly improve perinatal outcome.