适当延长妊娠期肝内胆汁淤积症孕妇孕周对围生儿结局的影响

发布时间：2018-05-21 15:00

本文选题：孕妇 + 肝内胆汁淤积症　；参考：《第三军医大学学报》2015年14期

【摘要】：目的回顾性分析1 697例妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)孕妇的临床资料,观察经积极处理后延长孕周对围生儿结局的影响,以降低ICP医源性早产的发生。方法 2003-2010年第三军医大学西南医院妇产科收治的1 697例ICP孕妇,分为2组,常规处理组为2003-2007年的孕妇,积极处理后延长孕周组为2008-2010年的孕妇;统计2组分娩孕周、早产率、围产儿的死胎发生率,分析围生儿结局的变化。结果 1 697例ICP孕妇共分娩1 761名胎儿,其中双胎妊娠64例。常规处理组孕妇980例,分娩胎儿1 017个,其中双胎37例;发生早产216例,早产率22.04%(216/980);发生胎死宫内9例,死胎发生率0.918%(9/980);医源性早产率为78.24%(169/216)。延长孕周组孕妇717例,共分娩胎儿744,其中双胎27例;早产99例,早产率13.8%(99/717);发生胎死宫内4例,死胎发生率0.55%(4/717);医源性早产率为54.54%(54/99)。与常规处理组比较,延长孕周组新生儿早产率、医源性早产率有明显降低(P0.05);而同期围生儿死亡率差异无显著性(P0.05)。结论 ICP经积极处理后,对孕妇和胎儿权衡利弊,动态观察,条件许可时尽可能延长胎龄,且不升高围生儿的死亡率,可降低医源性早产的发生。
[Abstract]:Objective to retrospectively analyze the clinical data of 1 697 pregnant women with intrahepatic cholestasis of pregnancy (IHG) and observe the effect of prolonged gestational weeks on perinatal outcome after active treatment in order to reduce the incidence of ICP iatrogenic preterm delivery. Methods from 2003 to 2010, 1 697 pregnant women with ICP were treated in Southwest Hospital of third military Medical University. They were divided into two groups: the routine treatment group was the pregnant woman from 2003 to 2007, and the extended gestational week group was the pregnant woman from 2008 to 2010 after active treatment. Incidence of perinatal stillbirth and analysis of perinatal outcome. Results 1 697 pregnant women with ICP gave birth to 1 761 fetuses, including 64 twin pregnancies. In the routine treatment group, 980 pregnant women and 1,017 fetuses were delivered, including 37 twins, 216 premature births, 21.6% 980% premature delivery, 9 intrauterine fetal death, 0.918 9% stillbirth, and 78.24% iatrogenic preterm delivery rate of 1699% / 21616%. There were 717 pregnant women in the prolonged gestational week group, including 744 fetuses, 27 twins, 99 premature births with a premature delivery rate of 13.8% / 717%, 4 cases with intrauterine fetal death, and 0.5554% 717% stillbirth rate, and a iatrogenic preterm delivery rate of 54.54% / 54%. Compared with the routine treatment group, the rate of premature delivery of newborns in prolonged gestational weeks group was significantly lower than that of normal treatment group, while the mortality rate of perinatal infants had no significant difference in the same period. Conclusion after active treatment, ICP can balance the advantages and disadvantages of pregnant women and fetuses, observe dynamically, prolong the gestational age as much as possible and do not increase the perinatal mortality when conditions permit, which can reduce the incidence of iatrogenic premature delivery.
【作者单位】：第三军医大学西南医院医院妇产科;重庆医科大学附属第二医院妇产科;
【分类号】：R714.7

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