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目的探讨双胎合并妊娠期肝内胆汁淤积症(ICP)的临床特点及其对围产儿预后的影响。方法回顾性分析本院分娩的7 696例孕妇的临床资料,选择双胎合并ICP的18例孕妇作为观察组,随机选择同期20例双胎非合并ICP孕妇为对照组,分析并比较两组孕妇的年龄、孕周等临床资料以及围生儿预后情况。结果本组中ICP发生率为1.96%(151/7 696),双胎孕妇中ICP发生率为12.00%(18/150),两者比较差异有统计学意义(P<0.01);观察组孕周明显短于对照组(P<0.01);观察组新生儿平均体重明显低于对照组(P<0.01);观察组新生儿窒息发生率为47.2%(17/36),明显高于对照组的12.5%(5/40),差异有统计学意义(P<0.01);观察组新生儿病死率为22.2%(8/36),明显高于对照组的5%(2/40),差异有统计学意义(P<0.05)。结论双胎合并ICP可明显升高新生儿窒息发生率及病死率,应加强围产期胎儿监护,一旦胎儿成熟或监护中发现异常应及时终止妊娠。
Objective To investigate the clinical characteristics of pregnancy complicated with intrahepatic cholestasis (ICP) and its effect on the prognosis of perinatal infants. Methods The clinical data of 7 696 pregnant women delivered in our hospital were retrospectively analyzed. 18 pregnant women with twins and ICP were selected as the observation group. Twenty pregnant women without twins at the same period were randomly selected as the control group. Age, gestational age and other clinical data and prognosis of perinatal children. Results The incidence of ICP in this group was 1.96% (151/7 696), and the incidence of ICP in twins pregnant women was 12.00% (18/150), with significant difference between the two groups (P <0.01) (P <0.01). The mean neonatal weight in the observation group was significantly lower than that in the control group (P <0.01). The incidence of neonatal asphyxia in the observation group was 47.2% (17/36), which was significantly higher than that in the control group (P <0.01). The neonatal mortality in the observation group was 22.2% (8/36), which was significantly higher than that in the control group (5/40), and the difference was statistically significant There was statistical significance (P <0.05). Conclusion The combination of twins with ICP can significantly increase the incidence of neonatal asphyxia and mortality, should strengthen the perinatal fetal care, once the fetus or guardianship abnormalities should be timely termination of pregnancy.