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[妊娠肝内胆汁淤积症孕妇血清胆汁酸水平与其新生儿状况的相关性]

[Correlation between serum levels of bile acids in pregnant women with intrahepatic cholestasis of pregnancy and condition of their newborns].

作者信息

Kowalski Artur, Janosz-Gałdyś Iwona, Olejek Anita, Bodzek Piotr

出版信息

Ginekol Pol. 2014 Feb;85(2):101-4. doi: 10.17772/gp/1698.

Abstract

OBJECTIVES

The aim of the study was to determine a relation between the level of total serum bile acids in pregnant women and the condition of their newborns on the basis of select parameters of acid-base balance in the cord blood.

MATERIAL AND METHODS

The study group consisted of 64 pregnant women with Intrahepatic Cholestasis of Pregnancy and 78 healthy pregnant women constituted the control group. Colorimetric enzymatic measurements of serum total bile acids were performed in both groups.

RESULTS

In the mild cholestasis group, mean concentration of bile acids amounted to 20.6 +/- 1.0 micromol/l and was statistically significantly lower as compared to women with severe cholestasis (58.9 +/- 9.5 micromol/l). In the control group, mean concentration of bile acids was 4.1 +/- 0.3 micromol/l and was statistically significantly lower as compared to groups with cholestasis. Caesarean section was performed in 60.9% of women with cholestasis as compared to 19.2% of controls. Also, neonatal condition in the first minute of life was worse in the group with cholestasis as compared to the infants in the control group. The body weight of newborns of mothers with cholestasis was statistically significantly lower than in infants born to controls. Lowered neonatal pH (below 7.20) was noted in 2.6% of the newborns from the control group and was statistically significantly less frequent as compared to infants from the group with cholestasis.

CONCLUSIONS

Periodic measurements of total bile acid concentrations in serum of pregnant women with cholestasis is of high value in establishing the diagnosis and determining severity of the disease in the mother as well as potential hazard for the fetus. Simultaneous monitoring of the changes total bile acids concentrations in the blood serum and the well-being allows to reduce the rates of neonatal distresses after birth and cesarean sections.

摘要

目的

本研究旨在基于脐血酸碱平衡的选定参数,确定孕妇血清总胆汁酸水平与其新生儿状况之间的关系。

材料与方法

研究组由64例妊娠肝内胆汁淤积症孕妇组成,78例健康孕妇作为对照组。两组均采用比色酶法测定血清总胆汁酸。

结果

轻度胆汁淤积组胆汁酸平均浓度为20.6±1.0微摩尔/升,与重度胆汁淤积组(58.9±9.5微摩尔/升)相比,差异有统计学意义。对照组胆汁酸平均浓度为4.1±0.3微摩尔/升,与胆汁淤积组相比差异有统计学意义。60.9%的胆汁淤积症孕妇进行了剖宫产,而对照组为19.2%。此外,与对照组婴儿相比,胆汁淤积组新生儿出生后第一分钟的状况更差。胆汁淤积症母亲所生新生儿的体重在统计学上显著低于对照组所生婴儿。对照组2.6%的新生儿pH值降低(低于7.20),与胆汁淤积组婴儿相比,其发生率在统计学上显著更低。

结论

对妊娠肝内胆汁淤积症孕妇血清总胆汁酸浓度进行定期测量,对于明确母亲疾病的诊断、确定疾病严重程度以及胎儿潜在风险具有很高价值。同时监测血清中总胆汁酸浓度变化和胎儿状况,有助于降低出生后新生儿窘迫和剖宫产的发生率。

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