妊娠期肝内胆汁淤积症对围产儿的影响

目的:探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)对围产儿结局的影响.方法:选择2000年1月～2002年12月以剖宫产分娩结束妊娠的ICP孕妇72例(病例组),观察其羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎的发生率,与同期行剖宫产分娩的70例正常孕产妇(对照组)的妊娠结局和新生儿结局进行对比分析,并行胎盘组织超微结构的电镜检查.结果:病例组羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎发生率分别为30.56%、23.61%、16.67%、5.56%、16.67%,与对照组相比差异有统计学意义(P＜0.05～0.01),病例组胎盘组织的超微结构有明显的异常改变.结论:ICP可导致羊水胎粪污染、胎儿窘迫、早产、新生儿窒息、新生儿吸入性肺炎.ICP胎盘的病理改变与围产儿结局有着密切的关系.

The effects on the perinatal newborn in intrahepatic cholestasis of pregnancy

Objective: To study the effects on perinatal newborn with ICP. Methods: From January 2000 to December 2002. 72 cases of pregnant women with ICP, who delivered by cesarean section were collected. To observe the amniotic fluid meconium contamination, fetal distress, premature delivery, asphyxia of newborn, neonatal aspiration pneumonia. 70 cases of normal pregnancy of similar age, who delivered by cesarean section, were used as control group. The ultrastructures of the placental tissue were studied with electronic microscope. Results:The percentage of amniotic fluid meconium contamination, fetal distress, premature delivery, asphyxia of newborn, neonatal aspiration pneumonia were 30.56%,23.61%, 16.67%, 5.56%, 16.67% respectively, which were significantly higher than that in control group (P<0.05~ 0.01). There was obvious pathologial change in the placental tissue ultrastructure in ICP group. Conclusion: ICP can induce premature delivery, fetal distress, asphyxia of newborn, amniotic fluid meconium contamination, neonatal aspiration pneumonia. The pathological change of the placental tissue ultrastructure closely is related to the prognosis of perinatal newborn.