The Influence Of Pregnancy Outcome Of Late Pregnant Women Complicated With Liver Dysfunction

ObjectiveThe purpose of this thesis is to investigate the etiology of liver dysfunction in latepregnancy and the influence of pregnancy outcomes in order to manage these high riskpregnant women, reduce or even avoid adverse pregnancy outcomes as much aspossible, promote maternal and infant safety and eugenics, through analyzingpregnancy outcomes between the late pregnant women complicated with liverdysfunction and the late pregnant women whose liver function were normal.MethodCollect the late pregnant women complicated with liver dysfunction(researchgroup) and the late pregnant women whose liver function were normal(control group)at the same term, these patients were hospitalized and delivered in the first affiliatedhospital of Fujian Medical University from June2008to December2012, carry on thereview analysis to these patient’s clinical material. The purpose of this thesis is toinvestigate the etiology of liver dysfunction in late pregnancy, and compare the twogroups of pregnant weeks、neonatal birth weight, hypertensive disorder complicatingpregnancy, gestational diabetes mellitus,postpartum hemorrhage, degree of hemoglobindecline in average before and after childbirth, blood coagulation disorders,meconium-stained amniotic fluid, fetal distress, premature rupture of membranes,premature delivery, fetal growth restriction, the positive of maternal’ s HBsAg positive,route of delivery ect. SPSS17.0system is the statistical method used for normal test,student t-test and chi-square test.ResultThe composition of courses of liver dysfunction in114cases of research term areas follow:36cases of Liver damage in pregnancy (31.6%),29cases of HBV relatedhepatitis (25.4%),16cases of hypertensive disorder complicating pregnancy (14.0%),13cases of intrahepatic cholestasis of pregnancy (ICP)caused (11.4%),10cases of HBV merger ICP (7.0%),4cases of HBV merger hypertensive disorder complicatingpregnancy(3.5%),3cases of of HBV merger ICP and hypertensive disordercomplicating pregnancy(3.5%),1case of HBV, hypertension, and ICP(0.9%),1caseof HEV hepatitis (0.9%),1case of acute fatty liver of pregnancy (0.9%). There are2cases diagnosed as liver cirrhosis, and both of them came postpartum hemorrhage.1case came liver failure, postpartum hemorrhage, and disseminated intravascularcoagulation (DIC).The average of pregnant weeks、neonatal birth weight in research group weresignificantly lower than the normal pregnancy group. Hypertensive disordercomplicating pregnancy, postpartum hemorrhage, degree of hemoglobin decline inaverage before and after childbirth, blood coagulation disorders, Meconium-stainedamniotic fluid, fetal distress, premature rupture of membranes, premature delivery werehigher than in normal pregnancy, and the differences are statistically significant.Although the rate of gestational diabetes mellitus (GDM)and cesarean delivery arehigher than in control group, the differences are not statistically significant.ConclusionHBV infected, hypertensive disorder complicating pregnancy and ICP were maincourses of the late pregnant women complicated with liver dysfunction. Serious liverdysfunction can result in liver cirrhosis, liver failure, and postpartum hemorrhage.The adverse pregnancy outcomes in research group were higher than control group.We should pay more attention on antenatal examination of the patients who withhigh-risk of liver dysfunction, sometimes is necessary to unite with specialists for thesehigh-risk pregnant women through standard treatment, management,in order to promotematernal and child safe.