目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis pregnancy,ICP)不同血清总胆汁酸(total bile acid,TBA)水平及不同终止妊娠时间对围产儿结局的影响。方法回顾性分析2013年3月至2017年6月我院住院分娩的198例ICP孕妇,根据血TB...目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis pregnancy,ICP)不同血清总胆汁酸(total bile acid,TBA)水平及不同终止妊娠时间对围产儿结局的影响。方法回顾性分析2013年3月至2017年6月我院住院分娩的198例ICP孕妇,根据血TBA水平分为10~<40μmol/L组(Ⅰ组)、40~<100μmol/L组(Ⅱ组)以及≥100μmol/L组(Ⅲ组),又根据终止妊娠孕周分为<36周组(A组)、36~36+6周组(B组)以及≥37周组(C组),统计各组围产儿不良结局发生情况。结果与ⅠB组及ⅠC组相比,ⅠA组的围产儿不良结局显著增高(P<0.05);与ⅠC组相比,ⅠB组低体质量儿发生率显著增高(P<0.05),NICU入住和近期并发症发生率低,但差异无统计学意义(P>0.05);与ⅡB组及ⅡC组比较,ⅡA组的围产儿不良结局显著增高(P<0.05);与ⅡC组相比,ⅡB组低体重儿及近期并发症发生率高,但差异无统计学意义(P>0.05),两组新生儿均未入住NICU。Ⅲ组发病孕周均早于34周,终止妊娠孕周<36者,围产儿不良结局发生率高。结论当血TBA在10~<40μmol/L时妊娠满37周终止妊娠有利于降低围产儿不良结局发生率;当TBA在40~<100μmol/L时,妊娠36周终止妊娠是降低围产儿不良结局的节点;当TBA≥100μmol/L应根据胎儿成熟度斟酌利弊终止妊娠。展开更多
目的探讨黄体酮疗法治疗先兆流产对妊娠期合并症及围生儿结局的影响和作用机制。方法选取2013年1月至2014年1月自贡市第三人民医院收治的150例早期先兆流产产妇作为观察组,给予黄体酮治疗;以同期收治的150例健康妊娠女性作为对照组。比...目的探讨黄体酮疗法治疗先兆流产对妊娠期合并症及围生儿结局的影响和作用机制。方法选取2013年1月至2014年1月自贡市第三人民医院收治的150例早期先兆流产产妇作为观察组,给予黄体酮治疗;以同期收治的150例健康妊娠女性作为对照组。比较两组产妇妊娠期合并症、围生儿结局及治疗前后血清孕酮、人孕激素诱导阻断因子(PIBF)水平等。结果两组产妇胎膜早破、胎盘早剥、胎盘前置、妊娠期高血压、妊娠期糖尿病及妊娠期胆汁淤积的妊娠期合并症发生率比较差异无统计学意义(P>0.05);两组分娩后1 min Apgar评分≤7分、难免流产、早产、活产儿、低体质量儿、巨大儿、胎儿窘迫及胎儿畸形的围生儿结局发生率比较差异无统计学意义(P>0.05)。观察组产妇治疗后血清孕酮水平[(87±14)nmol/L]显著高于对照组[(73±10)nmol/L]和治疗前[(77±11)nmol/L],差异有统计学意义(P<0.05);观察组产妇治疗前血清PIBF水平显著低于对照组[(316±71)nmol/L比(382±90)nmol/L](P<0.05),两组产妇治疗后血清PIBF水平显著高于治疗前,差异有统计学意义(P<0.05)。两组产妇治疗后PIBF水平比较差异无统计学意义(P>0.05)。结论黄体酮疗法治疗先兆流产可有效降低妊娠期合并症发生风险,并改善围生儿结局;而这一治疗作用与黄体酮上调血清PIBF水平密切相关。展开更多
Background：No national research on maternal and fetal complications and outcomes has been carried out in the mainland of China in recent years.This study was to provide a scientific basis for better control of obstet...Background：No national research on maternal and fetal complications and outcomes has been carried out in the mainland of China in recent years.This study was to provide a scientific basis for better control of obstetrical and neonatal diseases and better allocation of medical resources by analyzing the epidemiological characteristics of obstetrical diseases in the mainland of China.Methods：Hospitalized obstetrical cases from 19 tertiary and 20 secondary hospitals in 14 provinces （nationally representative） during the period January 1,2011 to December 31,2011 were randomly selected.The general condition,pregnancy complications,and perinatal outcomes of the patients were studied.Results：The top five medical and surgical complications of pregnant women in the mainland of China were anemia （6.34％）,uterine fibroids （2.69％）,thyroid disease （1.11％）,thrombocytopenia （0.59％）,and heart disease （0.59％）.The incidences of premature rupture of membranes （PROM）,preterm birth,prolonged pregnancy,hypertensive disorders complicating pregnancy （HDCP）,multiple pregnancy,intrahepatic cholestasis of pregnancy （ICP）,placenta previa,placental abruption,postpartum hemorrhage,and amniotic fluid embolism were 15.27％,7.04％,6.71％,5.35％,1.57％,1.22％,1.14％,0.54％,3.26％ and 0.06％,respectively.The incidences of anemia and prolonged pregnancy were significantly lower in tertiary than secondary hospitals （P ＜ 0.001）,whereas the incidence of uterine fibroids,thyroid diseases,thrombocytopenia,heart disease,PROM,preterm birth,HDCP,multiple pregnancy,ICP,placenta previa,and placental abruption were significantly higher in tertiary than secondary hospitals （P ＜ 0.001）.The cesarean section （CS） rate was 54.77％.The newborn sex ratio was 119：100,and 1.03％ of the neonates were malformed.The percentages of low birth weight and fetal macrosomia in full-term babies were 2.10％ and 7.09％,respectively.Conclusions：The incidence of some obstetrical diseases is still h展开更多
文摘目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis pregnancy,ICP)不同血清总胆汁酸(total bile acid,TBA)水平及不同终止妊娠时间对围产儿结局的影响。方法回顾性分析2013年3月至2017年6月我院住院分娩的198例ICP孕妇,根据血TBA水平分为10~<40μmol/L组(Ⅰ组)、40~<100μmol/L组(Ⅱ组)以及≥100μmol/L组(Ⅲ组),又根据终止妊娠孕周分为<36周组(A组)、36~36+6周组(B组)以及≥37周组(C组),统计各组围产儿不良结局发生情况。结果与ⅠB组及ⅠC组相比,ⅠA组的围产儿不良结局显著增高(P<0.05);与ⅠC组相比,ⅠB组低体质量儿发生率显著增高(P<0.05),NICU入住和近期并发症发生率低,但差异无统计学意义(P>0.05);与ⅡB组及ⅡC组比较,ⅡA组的围产儿不良结局显著增高(P<0.05);与ⅡC组相比,ⅡB组低体重儿及近期并发症发生率高,但差异无统计学意义(P>0.05),两组新生儿均未入住NICU。Ⅲ组发病孕周均早于34周,终止妊娠孕周<36者,围产儿不良结局发生率高。结论当血TBA在10~<40μmol/L时妊娠满37周终止妊娠有利于降低围产儿不良结局发生率;当TBA在40~<100μmol/L时,妊娠36周终止妊娠是降低围产儿不良结局的节点;当TBA≥100μmol/L应根据胎儿成熟度斟酌利弊终止妊娠。
文摘目的探讨黄体酮疗法治疗先兆流产对妊娠期合并症及围生儿结局的影响和作用机制。方法选取2013年1月至2014年1月自贡市第三人民医院收治的150例早期先兆流产产妇作为观察组,给予黄体酮治疗;以同期收治的150例健康妊娠女性作为对照组。比较两组产妇妊娠期合并症、围生儿结局及治疗前后血清孕酮、人孕激素诱导阻断因子(PIBF)水平等。结果两组产妇胎膜早破、胎盘早剥、胎盘前置、妊娠期高血压、妊娠期糖尿病及妊娠期胆汁淤积的妊娠期合并症发生率比较差异无统计学意义(P>0.05);两组分娩后1 min Apgar评分≤7分、难免流产、早产、活产儿、低体质量儿、巨大儿、胎儿窘迫及胎儿畸形的围生儿结局发生率比较差异无统计学意义(P>0.05)。观察组产妇治疗后血清孕酮水平[(87±14)nmol/L]显著高于对照组[(73±10)nmol/L]和治疗前[(77±11)nmol/L],差异有统计学意义(P<0.05);观察组产妇治疗前血清PIBF水平显著低于对照组[(316±71)nmol/L比(382±90)nmol/L](P<0.05),两组产妇治疗后血清PIBF水平显著高于治疗前,差异有统计学意义(P<0.05)。两组产妇治疗后PIBF水平比较差异无统计学意义(P>0.05)。结论黄体酮疗法治疗先兆流产可有效降低妊娠期合并症发生风险,并改善围生儿结局;而这一治疗作用与黄体酮上调血清PIBF水平密切相关。
文摘Background：No national research on maternal and fetal complications and outcomes has been carried out in the mainland of China in recent years.This study was to provide a scientific basis for better control of obstetrical and neonatal diseases and better allocation of medical resources by analyzing the epidemiological characteristics of obstetrical diseases in the mainland of China.Methods：Hospitalized obstetrical cases from 19 tertiary and 20 secondary hospitals in 14 provinces （nationally representative） during the period January 1,2011 to December 31,2011 were randomly selected.The general condition,pregnancy complications,and perinatal outcomes of the patients were studied.Results：The top five medical and surgical complications of pregnant women in the mainland of China were anemia （6.34％）,uterine fibroids （2.69％）,thyroid disease （1.11％）,thrombocytopenia （0.59％）,and heart disease （0.59％）.The incidences of premature rupture of membranes （PROM）,preterm birth,prolonged pregnancy,hypertensive disorders complicating pregnancy （HDCP）,multiple pregnancy,intrahepatic cholestasis of pregnancy （ICP）,placenta previa,placental abruption,postpartum hemorrhage,and amniotic fluid embolism were 15.27％,7.04％,6.71％,5.35％,1.57％,1.22％,1.14％,0.54％,3.26％ and 0.06％,respectively.The incidences of anemia and prolonged pregnancy were significantly lower in tertiary than secondary hospitals （P ＜ 0.001）,whereas the incidence of uterine fibroids,thyroid diseases,thrombocytopenia,heart disease,PROM,preterm birth,HDCP,multiple pregnancy,ICP,placenta previa,and placental abruption were significantly higher in tertiary than secondary hospitals （P ＜ 0.001）.The cesarean section （CS） rate was 54.77％.The newborn sex ratio was 119：100,and 1.03％ of the neonates were malformed.The percentages of low birth weight and fetal macrosomia in full-term babies were 2.10％ and 7.09％,respectively.Conclusions：The incidence of some obstetrical diseases is still h
