论文部分内容阅读
目的探讨妊娠期肝内胆汁淤积症(ICP)合并妊娠期糖尿病(GDM)的围生期母儿结局。方法选取2010年1月—2015年1月中国人民解放军第451医院住院分娩ICP合并GDM者16例(研究组),单纯ICP 105例(对照组),分别观察两组并发症及分娩情况、围生儿结局。结果研究组妊娠期高血压疾病(PHI)、重度ICP发生率分别为12.5%(2/16)和25.0%(4/16),高于对照组的1.0%(1/105)和4.8%(5/105),差异有统计学意义(P=0.046和0.018)。研究组平均分娩时孕周为36.6周,对照组为36.7周,差异无统计学意义(P=0.545)。研究组早产发生率为25.0%(4/16),高于对照组的3.8%(4/105),差异有统计学意义(P=0.001)。两组剖宫产率分别为87.5%(14/16)和85.7%(90/105),差异无统计学意义(P=0.848)。两组羊水粪染、胎膜早破、胎儿窘迫、胎儿畸形、新生儿窒息、围生儿死亡、巨大儿、低出生体质量儿发生率比较,差异无统计学意义(P>0.05);研究组新生儿低血糖发生率高于对照组,差异有统计学意义(P<0.05)。研究组新生儿1 min Apgar评分为8.25分,低于对照组的8.87分,差异有统计学意义(P=0.02)。结论 ICP合并GDM使围生期母儿患病率增加,临床应严密监护、个体化治疗,适时终止妊娠,可降低围生期母儿患病率。
Objective To investigate the perinatal maternal and neonatal outcome of intrahepatic cholestasis of pregnancy (ICP) with gestational diabetes mellitus (GDM). METHODS: From January 2010 to January 2015, 16 cases (study group) and 105 cases (control group) of hospitalized delivery ICP with GDM in 451 Hospital of People’s Liberation Army of China were enrolled in this study. The complication and delivery were observed respectively. Baby outcome. Results The incidences of PHI and severe ICP in the study group were 12.5% (2/16) and 25.0% (4/16) respectively, which were higher than 1.0% (1/105) and 4.8% 5/105), the difference was statistically significant (P = 0.046 and 0.018). The mean gestational age in the study group was 36.6 weeks and 36.7 weeks in the control group, with no significant difference (P = 0.545). The incidence of preterm birth in the study group was 25.0% (4/16), which was higher than that in the control group (3.8%, 4/105). The difference was statistically significant (P = 0.001). The rate of cesarean section in the two groups was 87.5% (14/16) and 85.7% (90/105) respectively, with no significant difference (P = 0.848). There were no significant differences in the incidence of meconium-stained amniotic fluid, premature rupture of membranes, fetal distress, fetal malformation, neonatal asphyxia, perinatal death, macrosomia and low birth weight (P> 0.05) Group neonatal hypoglycemia incidence was higher than the control group, the difference was statistically significant (P <0.05). The 1-minute Apgar score of the study group was 8.25 points, which was lower than that of the control group (8.87 points), the difference was statistically significant (P = 0.02). Conclusion ICP combined with GDM increased the prevalence of perinatal maternal and childbirth should be closely monitored, individualized treatment, timely termination of pregnancy, can reduce the prevalence of perinatal mother and child.