Antenatal Prediction To Effects Of Intrahepatic Cholestasis Of Pregnancy On Perinatal Outcome

Objective:To investigate the relation between maternal serum biochemical indexes which include CG, TBIL, DBIL ,ALT, AST and prognosis of fetuses which were measured by umbilical cord arterial blood gas analysis and the area of placenta intervillous space and the area of zygote cell nodule in ICP.Methods:1. The concentration of serum CG, TBIL, DBIL, ALT, AST were measured half an hour before cesarean section in 60 cases of ICP and 25 cases of normal pregnant women. Serum CG were measured by RIA, serum TBIL, DBIL ,ALT, AST were measured by biochemical autoanalyzer. 2. PO2, pH and PCO2 of umbilical cord arterial blood had been measured at the time before respiratory of fetus began during cesarean section.3. Area of placenta intervillous space and area of zygote cell nodule were measured by computer image analysis system.Results:1. The concentration of serum CG, TBIL, DBIL, ALT, AST in serum from patients with ICP were higher than in normals. (39.351±9.523μg/ml vs. 3.718±2.287μg/ml, P<0.01) , (28.067±5.886μmol/l vs. 9.175±2.014μmol/l , P<0.01) , (18.326±3.608μmol/l vs. 3.528±1.863μmol/l, P<0.01) , (131.258±11.795U/l vs. 48.763 ±5.679U/l , P<0.01) , (123.519±9.541U/l vs. 36.124±4.326U/l , P<0.01).2. The pH and PO2 of umbilical cord arterial blood were perfectly lower in ICP cases than in normals. (7.241±0.061 vs. 7.287±0.050, P<0.01), (19.350±4.878mmHg vs 24.640±6.382mmHg, P<0.01), whereas PCO2 in ICP cases was higher than in normals. (46.233±7.108mmHg vs. 42.680±6.142mmHg, P<0.05).3. Both actual area of placenta intervillous space and percentage of the area were perfectly smaller in ICP cases than in normals. (6.279±1.115μm2 vs. 7.155±0.187μm2, P<0.01) , (28.025±3.424% vs. 35.563±3.371% , P<0.01). Whereasarea of zygote cell nodule in ICP cases were larger than in normals. (4.182±1.184 μm2 vs. 1.176±0.757μm2, P<0.01), (15.506±5.460% vs. 5.242±1.391%, P<0.01).4. In ICP cases there were significant positive correlations between maternal serum CG, DBIL, ALT, TBIL, AST and pH, PO2 of umbilical cord arterial blood , whereas there were significant negative correlations between maternal serum biochemical indexes and PCO2 of umbilical cord arterial blood.5. In ICP cases there were significant positive correlations between maternal serum CG, DBIL, ALT, TBIL, AST and area of placenta intervillous space, whereas there were significant negative correlations between maternal serum biochemical indexes and area of zygote cell nodule.Conclusion: It is easier for ICP fetuses to have distress. The maternal serum CG, DBIL, ALT, TBIL, AST reflect the severity of ICP. ICP patients must be taken great care of by examination of serum biochemical indexes and treat in time.