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妊娠期肝内胆汁淤积症的母婴结局

Maternal and Neonatal Outcomes in Intrahepatic Cholestasis of Pregnancy.

作者信息

Granese Roberta, Calagna Gloria, Alibrandi Angela, Martinelli Canio, Romeo Paola, Filomia Roberto, Ferraro Maria Immacolata, Piccione Eleonora, Ercoli Alfredo, Saitta Carlo

机构信息

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University Hospital "G. Martino", Via Consolare Valeria 1, Gazzi, 98100 Messina, Italy.

Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Via Trabucco 180, 90127 Palermo, Italy.

出版信息

J Clin Med. 2023 Jun 30;12(13):4407. doi: 10.3390/jcm12134407.

Abstract

The aims of our study were to evaluate the maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP). In this observational, retrospective case-control study, we included all pregnant women who gave birth with a diagnosis of ICP between January 2010 and December 2020 at the Unit of Obstetrics and Gynecology, University Hospital of Messina. The data were compared with those from a control group of pregnant women who did not have ICP. One hundred twenty-nine and eighty-five patients were included, respectively, in the study and in the control group. There was a significant difference between the two groups in the incidence of hypothyroidism, thrombophilia, gestational diabetes, gestational hypertension, postpartum hemorrhage, and preterm delivery, which were more frequent in the ICP patients. No neonatal adverse events were recorded, although a significant difference in the meconium-stained amniotic fluid condition was noted. After a 24-month follow-up, 48/129 patients with ICP accepted to be reassessed by liver ultrasound, elastographic examination, and liver function blood tests. No patient showed signs of chronic liver disease. This study confirmed a higher probability of adverse short-term maternal outcomes in ICP pregnant patients, but a lower probability of adverse short-term fetal outcomes and the absence of a long-term maternal risk of chronic liver disease.

摘要

我们研究的目的是评估妊娠期肝内胆汁淤积症(ICP)的母婴结局。在这项观察性、回顾性病例对照研究中,我们纳入了2010年1月至2020年12月期间在墨西拿大学医院妇产科分娩且诊断为ICP的所有孕妇。将这些数据与未患ICP的孕妇对照组的数据进行比较。研究组和对照组分别纳入了129例和85例患者。两组在甲状腺功能减退、血栓形成倾向、妊娠期糖尿病、妊娠期高血压、产后出血和早产的发生率上存在显著差异,这些情况在ICP患者中更为常见。尽管在羊水胎粪污染情况上存在显著差异,但未记录到新生儿不良事件。经过24个月的随访,129例ICP患者中有48例接受了肝脏超声、弹性成像检查和肝功能血液检查的重新评估。没有患者表现出慢性肝病的迹象。这项研究证实,ICP孕妇出现不良短期母儿结局的可能性较高,但不良短期胎儿结局的可能性较低,且不存在慢性肝病的长期母儿风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfbd/10342617/8564eb549b24/jcm-12-04407-g001.jpg

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