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应对围产期挑战:妊娠胆汁淤积症及其对母婴健康影响的全面综述

Navigating Perinatal Challenges: A Comprehensive Review of Cholestasis of Pregnancy and Its Impact on Maternal and Fetal Health.

作者信息

Abdul Waheed Mohammed Irfan, Jaiswal Arpita, Yelne Seema, Nandanwar Varsha

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Apr 21;16(4):e58699. doi: 10.7759/cureus.58699. eCollection 2024 Apr.

Abstract

Cholestasis of pregnancy (CP), or intrahepatic CP (ICP), represents a condition peculiar to pregnancy, marked by impaired bile acid flow and consequent accumulation in the maternal bloodstream. Primarily emerging in the third trimester, CP is linked with considerable risks to both the mother and fetus, including heightened incidences of preterm birth, fetal distress, and stillbirth, alongside maternal complications such as intense pruritus and liver dysfunction. Despite its clinical significance, the etiology of CP, which involves genetic, hormonal, and environmental factors, remains partially understood. This comprehensive review delves into the physiology and pathophysiology of CP, outlines its clinical manifestations and diagnostic criteria, and discusses the associated maternal and fetal complications. Furthermore, it evaluates current management strategies, prognostic implications, and potential long-term effects on maternal and child health. It also explores future research directions, emphasizing the need for advancements in understanding the pathophysiology of CP, developing novel therapeutic interventions, and improving risk stratification models. By offering a thorough overview of CP, this review aims to enhance clinical awareness, guide management practices, and identify areas requiring further investigation, ultimately contributing to better health outcomes for affected women and their babies.

摘要

妊娠期肝内胆汁淤积症(CP),即肝内妊娠期胆汁淤积症(ICP),是一种妊娠期特有的病症,其特征为胆汁酸流动受损,继而在母体血液循环中蓄积。CP主要在妊娠晚期出现,与母亲和胎儿面临的重大风险相关,包括早产、胎儿窘迫和死产发生率增加,以及诸如剧烈瘙痒和肝功能障碍等母体并发症。尽管其具有临床重要性,但CP的病因(涉及遗传、激素和环境因素)仍未完全明了。这篇综述深入探讨了CP的生理和病理生理机制,概述了其临床表现和诊断标准,并讨论了相关的母体和胎儿并发症。此外,它评估了当前的管理策略、预后意义以及对母婴健康的潜在长期影响。它还探讨了未来的研究方向,强调了在理解CP病理生理机制、开发新的治疗干预措施以及改进风险分层模型方面取得进展的必要性。通过全面概述CP,本综述旨在提高临床认识,指导管理实践,并确定需要进一步研究的领域,最终为受影响的妇女及其婴儿带来更好的健康结果。

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