Clinical Study On The Effect Of Gestational Age And Clinical Index On Perinatal Outcome In Patients With Intrahepatic Cholestasis

Objective:Explore the effect of early diagnosis, the gestational age and the dividing degree of mild and severe to maternal and fetal outcomes in women of intrahepatic cholestasis pregnancy.Methods:100cases normal pregnancy women and150cases women with ICP were retrospectively analyzed during May2012-March2014in the Department of obstetrics, Yangzhou clinical medical college. The relationship was compared in different facts with the pregnancy outcome in ICP.Result:1. Intrahepatic Cholestasis Pregnancy occurred mostly between28weeks and37weeks,few occurred befor28weeks or after37weeks, Women of ICP appeared different clinical symptoms, signs and the results of laboratory tests.2. The incidence of increased serum CG was10%(10/100) in normal pregnancy and100%(150/150) in ICP women separately. The incidence of increased serum TBA was0%in normal pregnancy and58.33%(87/150) in ICP women separately.3. Gestational age of pregnancy women below28weeks, perinatal mortality rate was16.67%(3/18), fetal asphyxia rate was11.11%(2/18); Gestational age of pregnancy women between28weeks+1-36weeks+6, perinatal mortality rate was2.85%(1/35), fetal asphyxia rate was5.71%(2/35); Gestational age of pregnancy women over37weeks, fetal asphyxia rate was14.29%(1/7).The earlier of gestational age with ICP was, the higher of incidence of postpartum hemorrhage, premature rupture of membranes, thrombocytopenia was.4. There was a significant difference between mild women with ICP and women in severe ICP with on perinatal mortality, meconium staining of amniotic fluid, fetal asphyxia, low birth weight, the incidence of turning to NICU, preterm birth rates, cesarean delivery rate, thrombocytopenia(P<0.05). There was no difference between two groups on postpartum hemorrhage, Premature rupture of membranes(P>0.05).Conclusion:1.Early diagnosis and timely treatment can improve maternal and infant outcomes.2.CG could be a more sensitive index in the diagnosis of ICP compared with the index of TBA, but TBA had an advantage over CG in the specificity of ICP especially in the severity of ICP. Both serum higher level TBA and CG could be an index which could assess and predict the perinatal outcome.3. There was a relationship between ICP pregnancy outcome and the gestational age. The earlier of the gestational age of ICP was, the greater of impact on maternal and fetal outcomes was.4. Pregnancy outcomes of ICP had close relationship with the dividing of ICP.Compared with mild patients with ICP, Patients with severe ICP had more serious influence on maternal and fetal. We should strengthen monitoring pregnancy women with ICP in order to prevent and reduce the occurrence of adverse pregnancy outcome and adverse perinatal outcomes.