112例妊娠期肝损害患者妊娠结局分析*

目的 分析妊娠期肝损伤对妊娠结局的影响。方法 2013年4月~2018年4月在我院分娩的妊娠期肝损害患者112例和同期分娩但肝功能正常的孕妇50例,分析比较两组分娩情况及母婴妊娠结局。结果 产前,肝损害孕妇血清ALT和AST峰值水平分别为（146.0±46.4） U/L和（112.5±50.1） U/L,产后均恢复正常;肝损害孕妇孕周、新生儿身长和出生60 s Apgar评分与健康孕妇组比,无统计学差异（P>0.05）,而产后出血量为（206.9±80.1） ml,新生儿体质量为（3086.3±252.4） g,与健康孕妇组比,差异显著【分别为（189.8±72.2） ml和（3302.7±320.1）g,P<0.05】;肝损害孕妇羊水性状清所占比例为65.2%,显著低于对照组的82.0%,而羊水Ⅲ度污染、早产、胎膜早破和胎儿宫内窘迫比例分别为23.2%、17.0%、25.9%和18.8%,显著高于对照组的8.0%、2.0%、12.0%和6.0%（P<0.05）。结论 妊娠期肝损害对母婴结局产生负面影响,可增加羊水污染、早产、胎膜早破或胎儿宫内窘迫发生风险。

Pregnancy outcomes in 112 patients with liver injuries during gestation periods

Objective The aim of this study was to investigate the pregnant outcomes in 112 patients with liver injuries during gestation periods. Methods A total of 112 patients with liver injuries during gestation periods and 50 healthy pregnant women with normal liver function tests were recruited in our hospital between April 2013 and April 2018,and the pregnant outcomes were recorded and compared between the two groups. Results Before delivery,serum alanine aminotransferase and aspartate aminotransferase peak levels in pregnant women with liver injuries were（146.0±46.4） U/L and （112.5±50.1） U/L,both returned back to normal after birth;the gestational duration,neonatal length and Apgar score at 60 s in pregnant women with liver injuries were not significantly different （P>0.05） as compared to those in control women,while postpartum blood loss was （206.9±80.1） ml,and neonatal body weight was （3086.3±252.4）g,much different as compared to those in the healthy women 【（189.8±72.2） ml and （3302.7±320.1） g,respectively,P<0.05】;the proportion of clean amniotic fluid in the women with liver injuries was 65.2%,much lower than 82.0% in the control,and the proportions of amniotic fluid contamination grade III,premature delivery,premature rupture of membranes and intrauterine neonatal respiratory distress in liver injury groups were 23.2%,17.0%,25.9% and 18.8%,significantly higher than 8.0%,2.0%,12.0% and 6.0% in the control group （P<0.05）. Conclusion Liver damage during gestation period might lead to untoward effects on maternal and fetal outcomes,which should taken into consideration and deal with carefully early.