全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

适当延长妊娠期肝内胆汁淤积症孕妇孕周对围生儿结局的影响

, PP. 1455-1459

Keywords: 孕妇,肝内胆汁淤积症,早产,妊娠结局

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的回顾性分析1697例妊娠期肝内胆汁淤积症(intrahepaticcholestasisofpregnancy,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1697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1697例ICP孕妇共分娩1761名胎儿,其中双胎妊娠64例。常规处理组孕妇980例,分娩胎儿1017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。

References

[1]  林安平, 严小丽, 王琳, 等. 妊娠期肝内胆汁淤积症早产与自发性早产临床结局的对比分析[J]. 实用妇产科杂志, 2011, 27(10): 775-777. [2]曹泽毅. 中华妇产科学[M]. 2版. 北京: 人民卫生出版社, 2005: 468-474. [3]林安平, 卢春冬, 王琳, 等. 1 340例妊娠期肝内胆汁淤积症的回顾性分析[J]. 中华围产医学杂志, 2010, 13(2): 102-106. [4]Bolier A R , Jebbink J M , van-der-Post J A , et al. Risks of intrahepatic cholestasis of pregnancy[J]. Ned Tijdschr Geneeskd, 2014, 158: A7713. [5]Gabzdyl E M, Schlaeger J M. Intrahepatic cholestasis of pregnancy: a critical clinical review[J]. J Perinat Neonatal Nurs, 2015, 29(1): 41-50. [6]Lee R H, Geenes V L, Williamson C. Primum non nocere: stillbirth rate in intrahepatic cholestasis of pregnancy[J]. Am J Obstet Gynecol, 2015, 212(3): 414. [7]Wikstrom-Shemer E, Marschall H U, Ludvigsson J F, et al. Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes: a 12-year population-based cohort study[J]. BJOG, 2013, 120(6): 717-723. [8]Saleh M M, Abdo K R. Intrahepatic cholestasis of pregnancy: review of the literature and evaluation of current evidence[J]. J Womens Health (Larchmt), 2007, 16(6): 833-841. [9]赵琳, 李琳霞, 李艳红, 等. 早产儿早产原因及并发症分析[J]. 中华妇幼临床医学杂志: 电子版, 2014, 10(5): 69-72. [10]张玲云, 王志华. 妊娠期肝内胆汁淤积症与早产关系的研究[J]. 中国妇幼保健, 2011, 26(1): 37-38. [11]徐洲, 王晓银, 肖兵. 妊娠期肝内胆汁淤积症分娩时机及方式探讨[J]. 中国计划生育和妇产科, 2014, 6(4): 62-64. [12]Perin E, Cacciaguerra G, Driul L, et al. Intrahepatic cholestasis of pregnancy: diagnosis and obstetric management[J]. Minerva Ginecol, 2010, 62(2): 97-103. [13]林安平, 王琳,常青. 妊娠期肝内胆汁淤积症围生儿死亡12例临床分析[J]. 实用妇产科杂志, 2010, 26(1): 71-73. [14]中华医学会妇产科学分会产科学组. 妊娠期肝内胆汁淤积症诊疗指南(第1版)[J]. 中华妇产科学杂志, 2011, 46(5): 391-395. [15]Grand’Maison S, Durand M, Mahone M. The effects of ursodeoxycholic acid treatment for intrahepatic cholestasis of pregnancy on maternal and fetal outcomes: a meta-analysis including non-randomized studies[J]. J Obstet Gynaecol Can, 2014, 36(7): 632-641. [16]Jain R, Suri V, Chopra S, et al. Obstetric cholestasis: outcome with active management[J]. J Obstet Gynaecol Res, 2013, 39(5): 953-959. [17]Brockbank A. Guideline for the Investigation and Treatment of Obstetric Cholestasis, NHS, 2010. [18]Royal College of Obstetricians and Gynaecologists (RCOG). Obstetric Cholestasis[M]. London: Royal College of Obstetricians and Gynaecologists (RCOG), 2011. [19]King Edward Memorial Hospital. Cholestasis in pregnancy Clinical Guidelines Section B (2010) [DB/OL]. http: //www. kemh. health. wa. gov. au/development/manuals/O&G_guidelines/sectionb/2/8858. pdf. [20]Arthur C, Mahomed K. Intrahepatic cholestasis of pregnancy: diagnosis and management; a survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows[J]. Aust N Z J Obstet Gynaecol, 2014, 54(3): 263-267.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133