妊娠期肝内胆汁淤积症胎儿监护及围产儿预后的关系

目的:探讨无负荷试验(NST)和脐动脉血流测定对妊娠期肝内胆汁淤积症(ICP)患者围产儿预后的监护价值。方法:联合应用多普勒测定脐动脉血流速度和胎心无负荷试验,对98例ICP患者(ICP组)及同期的98例正常孕妇(对照组)进行比较。结果:①ICP组胎儿宫内窘迫、新生儿窒息、围产儿死亡的发生率明显高于对照组(P<0.05)。②ICP组脐动脉收缩期最大血流速度与舒张末期血流速度比值(S/D)和胎儿无负荷试验异常发生率明显高于对照组,差异有显著性(P<0.01)。③ICP组中NST、脐血流S/D值结果异常的病例,围产儿预后不良的发生率明显高于结果正常组(P<0.005)。结论:对ICP病例应常规进行NST检查和脐动脉血流S/D测定,以早期发现胎儿宫内窘迫并给予及时处理,可有效改善围产儿预后。

The correlation between prognosis of fetal electrical monitoring and perinatal fetal in intrahepatic cholestasis of pregnancy

Objective:To evaluate the monitoring value of nonstress test(NST)and umbilical artery flow velocity for patients with intrahepatic cholestasis in pregnancy(ICP).Methods:NST and fetal umbilical artery flow velocity were used in 98 patients with ICP and 98 normal pregnant women.Results:①The incidence,for fetal distress,asphyxia of newborn and perinatal mortality rate was significantly higher in ICP group than that in control group(P<0.05).②Ratio for blood stream speed,between contraction stage and diastole last stage(S/D),and abnormality rate in fetal non-stress test was significantly higher,there were significant difference(P<0.01).③The incidence of poor perinatal outcome in patients with abnomal NST and S/D was significantly higher than that of the control(P<0.05).Conclusion:NST and umbilical artery flow S/D ratio analysis should be conventional in ICP cases,to early detect fetal distress and to prompt processing,which can effectively improve perinatal outcome.