妊娠期肝内胆汁淤积症分娩时机及方式探讨

目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)分娩时机及方式对母儿结局的影响。方法对228例ICP病例进行回顾性研究,分析ICP患者终止妊娠的时机及方式与母儿结局的关系。结果重度ICP组早产儿、低体重儿、羊水粪染、新生儿窒息率显著高于轻度ICP组(P0.05);轻度ICP组孕37~40周阴道分娩与剖宫产比较母儿结局无差异(P0.05)。结论轻度ICP患者孕37~40周阴道分娩为宜;重度ICP患者胎肺成熟后以选择性剖宫产终止妊娠为宜。

A study on the timing and manner of delivery in patients with intrahepatic cholestasis of pregnancy

Objective To investigate the relationship between the timing and manner of delivery and prognosis in patients with intrahepatic cholestasis of pregnancy（ ICP）. Methods 228 patients with ICP were analyzed retrospectively,the relationship between the timing and manner of delivery and the maternal and neonatal outcomes were evaluated. Results The rates of preterm children,low birth weight children,meconium - stained amniotic fluid, neonatal asphyxia of the severe ICP patients were significantly higher than the mild ICP patients（P〈 0. 05）. There was no significant difference in maternal and neonatal outcomes in the mild ICP patients who took vaginal or cesarean delivery at 37 ～ 40 weeks of pregnancy（P〉 0. 05）. Conclusion Vaginal delivery at 37 ～ 40 weeks is appropriate for the mild ICP patients. Elective cesarean section after fetal lung maturity is appropriate for severe ICP patients.