Biochemical Character And Perintal Outcome Characteristics Of Early Onset Evtrahepatic Cholestasis Of Pregnancy

ObjectiveTo analyze biochemical character and perinatal outcome characteristics of early onset intrahepatic cholestasis of pregnancy(ICP).MethodAll298ICP cases were collected in the First Afiliated Hospital of Chongqing Medical University between Jun2006and Jun2011. According to the onset time of ICP all subjects were divided into:early onset ICP group(onset time<28gestational week), late onset ICP group(onset time≥28gestational week); and the late onset ICP group was divided into:28～31+6gestational week group&≥32gestational week group. The biochemical character concentrations and perinatal outcome characteristics of each group were assessed.Results(1) When first diagnosis, the maternal serum concentrations of TBA in early onset ICP was (47.15±45.54)μmol/L,28～31+6gestational week group was (39.89±30.13)μmol/L,>32gestational week group was (30.94±30.51)μmol/L, the difference between three groups was statistically significant(P<0.05). The maternal serum concentrations of BIL in early onset ICP was (31.06±30.44) μmol/L, it were higher than28～31+6&≥32gestational week group(P<0.05), the difference between the last two groups was not statistically significant(P>0.05). There were not significant difference in ALT and AST between three groups(P>0.05).(2) In early onset ICP, the incidences of meconium staining, fetal distress, newborn asphyxia were19.51%,21.95%,14.63%, it were all higher than28～31+6gestational week group (8.33%,10.00%,6.91%)&≥32gestational week group (7.11%,8.63%,5.08%)(P<0.05), the difference between the last two groups was not statistically significant(P>0.05). The incidence of stillbirth were not significant different between three groups (P>0.05).(3) In early onset ICP, the incidences of premature, severe ICP, cesarean section were29.27%,39.02%,90.24%, it were all higher than28～31+6gestational week group (20.00%,30.00%,83.33%)&≥32gestational week group (14.21%,23.86%,77.16%)(P<0.05), the difference of the incidences of premature, severe ICP, cesarean section between28～31+6&≥32gestational week group was not statistically significant (P>0.05). The difference of delivery timing were statistically significant between three groups([P<0.01).ConclusionThe patient’s illness of early onset ICP was more serious than late onset ICP, and early onset ICP is more likely to lead to fetal distress and premature, it is necessary to be early diagnosis and treatment, timely terminating pregnancy to improve perinatal outcome.