The Opportunity And The Manner Of Delivery On Intrahepatic Cholestasis Of Pregnancy

ObjectiveTo investigate manifestations of intrahepatic cholestasis of pregnancy(ICP) and pregnancy outcomes, and to explore the opportunity and themanner of termination of pregnancy.MethodsThe data of 249 cases of ICP in 5 monthes (between January 2007 to June 2007)were retrospectively analyzed. There are 13 cases twins, 11cases complicating hypertension of pregnancy, 1 case complicating systemic lupus erythematosus, 1 case complicating fetal anomaly, 1 case is dead foetus. Maternal pruritus, Glycocholic Acid, Total Bilirubin, Alanine Aminotransferase, Aspartate Aminotransferase, Total Bile Aacid, the time and the way of termination of pregnancy, Apgar score were examinated. The datas were classified by the values of CG and the gestational week of delivery. ResultsThree groups were classified by the values of CG: Group A(CG< 1000ug/dl), GroupB (1000ug/dl≤CG<3000ug/dl) , Group C(CG≥3000ug/dl).1,The rates of increased Total Bilirubin, Alanine Aminotransferase,Aspartate Aminotransferase, Total Bile Aacid are increase with the increase of the values of CG, were statistically different(P<0.01).2,There is no significant difference in the incidence rate ofhypamnion. The incidence rate of Meconium Stained Amniotic Fluid are 14.77%, 15.75%, 23.53%, were statistically different(P<0.01).3,The rates of preterm delivery increase,with the increase of the valuesof CG, were statistically different(P<0.01).4,The incidence rate of cesarean section are 73.86%, 92.91%, 97.06%,were statistically different (P<0.01).5,The incidence rate of pruritus are 16.82 %, 18.11 %, 38.24%, werestatistically different(P<0.01).Conclusion1. The guidelines for treatment of ICP introduce the assessment of serum values of CG in diagnostics as the most important indicator.2. When the disease is aggravate or to recur after treatment ,ddivery has been recommended in the 32th-34th week when lung maturity has been established by using DXM. Mostly patients of ICP labour in 37weeks gestation delivery, when the values of CG is < 1000ug/dl. 3. The incidence rate of cesarean section is high. Cesarean section is more safer for premature fetus, but ICP isn't the absolute indication of cesarean section. If the values of CG is <1000ug/dl, Vaginal delivery is feasible under rigor monitoring.