妊娠期肝内胆汁淤积症胎儿监护与围生儿预后关系分析

目的:探讨对妊娠期肝内胆汁淤积症(ICP)孕妇进行胎儿监护的临床价值。方法:对223例ICP孕妇进行无负荷试验(NST),其中89例进行缩宫素激惹试验(OCT),所有孕妇均进行超声脐动脉血流分析及肝功能检测。结果:OCT和超声脐血流分析结果异常者的围生儿预后不良发生率分别为63.89%和21.43%,明显高于正常者的16.98%和11.11%(P<0.05,P<0.05)。NST正常者和异常者的围生儿预后不良发生率无明显差异。ICP患者的胎儿窘迫、新生儿窒息、早产、胎儿电子监测异常及脐血流异常高于正常组。ICP组中总胆汁酸大于50μmol/L组的胎儿电子监护异常及脐血流S/D值异常的发生率,均高于其他两组。结论:OCT和超声脐动脉血流分析对了解ICP孕妇胎盘功能和预测围生儿预后具有较高的临床价值。

Relationship between Fetal Electrical Monitoring and Neonatal Outcome in ICP

Objective:To study the clinical value of fetal monitoring in ICP.Methods:223 cases were examined with the fetal monitoring,ultrasonic umbilical artery flow analysis(UAFA) and liver function test;among whom 89 cases were tested with CST or OCT.Results:The incidence of poor perinatal outcome in cases with abnormal OCT or UAFA were 63.89% and 21.43% respectively,both were significantly higher than that from patients with normal results(16.98% and 11.11% respectively,P<0.05),There is no difference of incidence of poor perinatal outcome between groups with normal and abnormal results in nonstress test(NST).The incidence of poor perinatal prognosis in high TBA groups was higher than that in low TBA groups.Conclusions: OCT and UAFA have the higher clinical value to detect the poor placental function and to foretell the perinatal prognosis in ICP. Grading of ICP based on liver function test may improve perinatal prognosis.