摘要
目的回顾性分析1 697例妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)孕妇的临床资料,观察经积极处理后延长孕周对围生儿结局的影响,以降低ICP医源性早产的发生。方法 2003-2010年第三军医大学西南医院妇产科收治的1 697例ICP孕妇,分为2组,常规处理组为2003-2007年的孕妇,积极处理后延长孕周组为2008-2010年的孕妇;统计2组分娩孕周、早产率、围产儿的死胎发生率,分析围生儿结局的变化。结果 1 697例ICP孕妇共分娩1 761名胎儿,其中双胎妊娠64例。常规处理组孕妇980例,分娩胎儿1 017个,其中双胎37例;发生早产216例,早产率22.04%(216/980);发生胎死宫内9例,死胎发生率0.918%(9/980);医源性早产率为78.24%(169/216)。延长孕周组孕妇717例,共分娩胎儿744,其中双胎27例;早产99例,早产率13.8%(99/717);发生胎死宫内4例,死胎发生率0.55%(4/717);医源性早产率为54.54%(54/99)。与常规处理组比较,延长孕周组新生儿早产率、医源性早产率有明显降低(P<0.05);而同期围生儿死亡率差异无显著性(P>0.05)。结论 ICP经积极处理后,对孕妇和胎儿权衡利弊,动态观察,条件许可时尽可能延长胎龄,且不升高围生儿的死亡率,可降低医源性早产的发生。
Objective To explore the effect of properly prolonging gestational age of pregnant women with intrahepatic cholestasis of pregnancy（ ICP） on perinatal outcomes. Methods A total of 1 697 pregnant women with ICP from January 2003 to December 2010 in Southwest hospital were divided into a routine treatment group（ pregnant women in 2003- 2007 year） and an active treatment group（ pregnant women in2008- 2010 year,receiving active treatment to prolong the gestational age）. The delivery gestational age,premature birth and perinatal stillbirth rate were statistically analyzed,and the perinatal outcomes were compared. Results The pregnant women aged from 20 to 41 years old,with mean age of（ 28. 2 ± 3. 8）years old and gestational age of 32- 41 weeks. There were 1 761 fetuses delivered,including 64 cases of twins. There were 980 pregnant women in the routine treatment group,with 1 017 fetuses delivered,including37 cases of twins. The routine treatment group included 216 cases of premature birth 22. 04%（ 216 /980）,9 cases of stillbirth 0. 918%（ 9 /980）,and 169 cases of iatrogenic premature birth 78. 24%（ 169 /216）.There were 717 pregnant women in the active treatment group,with 744 fetuses delivered,including 27 cases of twins. The active treatment group included 99 cases of premature birth 13. 8%（ 99 /717）,4 cases of stillbirth 0. 55%（ 4 /717）,and 54 cases of iatrogenic premature birth 54. 54%（ 54 /99）. Compared with the routine treatment group,the active treatment group had significantly reduced newborn premature birth rate and iatrogenic premature birth rate（ P〈0. 05）,but during the same period,the perinatal mortality of both the groups had no significant difference（ P〈0. 05）. Conclusion After active treatment for ICP,the pregnant women and fetuses receive dynamic observation,and the gestational age is prolonged as long as possible if the conditions are permitted,which can reduce the incidence of iatrogenic premature birth without increase of perinatal mortality.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2015年第14期1455-1459,共5页
Journal of Third Military Medical University
关键词
孕妇
肝内胆汁淤积症
早产
妊娠结局
pregnant women
intrahepatic cholestasis
premature birth
pregnancy outcome
