Study Of Fetal Lung Injury In Intrahepatic Cholestasis Of Pregnancy

Objective:To evaluate fetal lung injury and the changes of fetal lung development in patients with ICP and its relationship with the bile acid, looking for the indicators of fetal lung injury for assessing children intrauterine perinatal conditions and provide the basis for early treatment.Methods:From Jul.2010 to Dec.2010, we selected 25 cases of patients with ICP for treatment as the study group in our hospital and randomly selected 25 cases of normal pregnant women for delivery as the control group during the same period. In the first 3 days of termination of pregnancy we assayed concentration of maternal serum total acid bile in their serum and detect fetal umbilical artery index of and fetal lung area/body weight ratio at synchronization. We collected amniotic fluid during cesarean and assayed lamellar body count. We collected umbilical arterial blood after delivery of fetal and measured umbilical artery total acid bile and blood gas analysis.Results(1) The TBA concentration in maternal blood and newborn umbilical artery of the study group were significantly higher than that of the control group. The difference was Statistically significant.(P<0.01) In the study group the TBA concentration in maternal blood and that in umbilical artery were positively correlated. (P<0.01) (2) The study group of fetal pulmonary artery S/D, RI, PI were significantly higher, the difference was statistically significant (P<0.01). LB and fetal lung area/body weight ratio were significantly lower than the control group, the difference was statistically significant.(P<0.01)(3) The PO2,PH,SO2 value in newborn umbilical artery of the study group were lower than that of the control group. The difference was statistically significant (P<0.01). Between the two groups PCO2 had no statistically significant difference.(P>0.05).(4) In study group the cord blood TBA was positively correlated with fetal pulmonary artery S/D, RI, and negativelycorrelated with LB, fetal lung area/body weight ratio.(P<0.01).(5) In study group fetal pulmonary artery RI was negatively correlated with LB and fetal lung area/body weight ratio. LB was positively correlated with fetal lung area/body weight ratio. (P<0.01)(6) In study group LB and fetal lung area/body weight ratio were positively correlated with PO2,PH, and negatively correlated with PCO2.Fetal pulmonary artery RI was negatively correlated with with PO2,PH, and positively correlated with PCO2. (P<0.01)(7) In study group neonatal asphyxia, respiratory distress were higher than those of the control group, the difference was Significance between the two groups. (P<0.05) (8) The children in the pathology of fetal perinatal pulmonary artery S/D, RI, PI were higher than children of non-perinatal pathology, and LB, fetal lung area/body weight ratio were lower than children of non-perinatal pathology, the difference was statistically significant.(P<0.05)(9) Perinatal pathology in study group pulmonary artery S/D, RI were higher than those of non-pathological perinatal in control group while LB, fetal lung area/body weight than lower those of non-pathological perinatal in control group, the difference was statistically significant. (P<0.05)Conclusion(1) Bile acid concentrations in maternal and neonatal umbilical arterial blood of ICP were elevated, and both have obvious relevance.(2) In ICP fetal presents lung injury, which elevated with the bile acid, and affects lung development and lung ventilation function.(3) Fetal pulmonary artery RI and fetal lung area/weight ratio for the early detection of ICP and assessment of fetal lung injury and the prognosis of perinatal children to determine treatment options all have some clinical significance.