早发型妊娠期肝内胆汁淤积症患者妊娠结局临床研究

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Abstract Objective: To analyze the clinical characteristics and perinatal outcome of early-onset intrahepatic cholestasis of pregnancy (ICP). Methods: A total of 226 ICP cases were collected in the Third Clinical College of Wenzhou Medical University between Jan 2010 and Dec 2013. According to the onset time of ICP, patients were divided into early-onset ICP group (onset time<28 gestational weeks) and late-onset ICP group (onset time≥28 gestational weeks), 200 normal pregnant women were randomly enrolled as controls. The levels of maternal serum total bile acid (TBA), total bilirubin (TBIL), alanine aminotransferase (ALT) and serum total bile acid (TBA) were evaluated. The perinatal outcome were assessed. Results: ①The maternal serum concentrations of TBA in early-onset ICP group were higher than that in late-onset ICP group before and after treatment, and the difference between the two groups was statistically significant (P<0.05). ②The early-onset ICP group had significant higher (P<0.05) incidence of admission to the neonatal unit compared to the late-onset ICP group and the control group. There was no significant difference (P<0.05) in incidence of premature delivery, fetal distress, fetal growth retardation, newborn asphyxia, cesarean section and average birth weight between the early-onset ICP group and the late-onset ICP group. ③The ICP group had significant higher (P<0.05) incidence of premature delivery, fetal distress, cesarean section and admission to the neonatal unit when compared to the control group. The average birth weight in the ICP group was lower than that in the control group. Conclusion: The ICP patients presents worse clinical manifestations than the controls. And ICP is much more likely to lead to fetal distress. The level of serum TBA is markedly elevated in the early-onset ICT patients. The incidence of admission to the neonatal unit is significantly higher compared to the controls. We can’t ignore the long-term management of patients with early-onset ICP.

Key words： cholestasis intrahepatic fetal distress fetal death pregnancy outcome

Received: 08 January 2015

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	CHEN Cong1
	CHEN Lingxiang1
	WU Xueqing2.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I8/597

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