妊娠期肝病2137例临床分析

目的 探讨妊娠期肝病的分布,各型肝病的产科预后及与产前医学干预的关系.方法 选择1993-2003年本院孕肝科收治的妊娠期肝病2 137例,统计各项指标的平均数据和构成比.结果 妊娠期合并病毒性肝炎1 503例,占70.3%,其中重症肝炎占4.05%.妊娠期特有肝病634例,其中妊娠胆汁淤积症占49.2%.妊娠期急性脂肪肝占12.3%.孕产妇死亡占0.75%,产后出血占11.7%.围产儿结局:死亡26例占1.34%,窒息17.1%,出生缺陷0.88%,早产儿16.1%,胎儿宫内窘迫13.25%.结论 妊娠期合并肝病中病毒性肝炎占主要地位.特发性肝病中主要有妊娠期肝内胆汁淤积症.最凶险的是妊娠合并重症肝炎和妊娠期急性脂肪肝.两种病毒以上的感染、双胎较易发生重症肝炎.早就诊早治疗是减少不良产科预后的有效方法.

Analysis of 2 137 cases of liver diseases in pregnant women

Objective To study the distribution of liver diseases in gestation period and the relations between the prognosis of patients, their new born babies and the prelabor medical intervention. Methods 2 137 patients in our hospital from 1993 to 2003 were analyzed and the results were treated according to standerd statistics method. Results Of all the patients, viral hepatitis were found in 1 503 cases(account for 70.3%). Among them, 61 cases with severe hepatitis(4.05%) and 634 with Hepatopathy especially related with pregnancy(HERP). 312 cases of them were intrahepatic cholestasis of pregnancy (ICP) and 78 were acute fatty liver of pregnancy. They account for 49.2% and 12.3% respectively. women with post partum bleeding account for 11.7%(251/2 137) and the mortality was 0.75%(16/2 137). Of all newborn babies, incidence of asphyxia,body defect, premature labor and fetal distress were 278( 13.0%), 19(0.88%), 347(16.23%), 285(13.33%) respectively. The death rate was 1.22%(26/ 2 137). Conclusion Viral hepatitis are more common in gravid women with liver diseases and ICP account for great part in HERP. The gestation accompanied by severe hepatitis and acute fatty liver of pregnancy was extremely hazondous to pregnant woman. The severe hepatitis is often seen in viral hepatitis caused by duplicate virus and twinborn women. The effective means of minimizing pregnant woman's and new born baby's mortality are early medical diagnosis and treatment.