妊娠期肝内胆汁淤积症胎儿监护与围生儿预后关系分析

摘要

Objective To study the clinical value of fetal monitoring in ICP. Methods 102 cases were examined with the fetal monitoring,ultrasonic umbilical artery flow analysis(UAFA) and liver function test;among whom 36 cases were tested with CST or OCT.Results The incidence of poor perinatal outcome in cases with abnormal OCT or UAFA were 66.67% and 25.00% respectively,both were significantly higher than that from patients with normal results(19.05% and 11.43% respectively,P < 0.01 or 0.05).There is no difference of incidence of poor perinatal outcome between groups with normal and abnormal results in nonstress test(NST).The incidence of poor perinatal prognosis in high TBA groups was higher than that in low TBA groups.Conclusions OCT and UAFA have the higher clinical value to detect the poor placental function and to foretell the perinatal prognosis in ICP.Grading of ICP based on liver function test may improve perinatal prognosis.%目的 探讨对妊娠期肝内胆汁淤积症(ICP)孕妇进行胎儿监护的临床价值.方法 对102例ICP孕妇进行无负荷试验(NST),其中36例进行缩宫素激惹试验(OCT),所有孕妇均进行超声脐动脉血流分析及肝功能检测.结果 OCT和超声脐血流分析结果 异常者的围生儿预后不良发生率分别为66.67%和25.00%,明显高于正常者的19.05%和11.43%(P＜0.01,P＜0.05).NST正常者和异常者的围生儿预后不良发生率无明显差异.ICP患者的胎儿窘迫、新生儿窒息、早产、胎儿电子监测异常及脐血流异常高于正常组.ICP组中总胆汁酸大于50μmol/L的胎儿电子监护异常及脐血流S/D值异常的发生率,均高于其他两组.结论 OCT和超声脐动脉血流分析对了解ICP孕妇胎盘功能和预测围生儿预后具有较高的临床价值.