A Study Of The Related Risk Factors Of The Prognosis And The Relation Between Clinic Management And Prognosis In Intrahepatic Cholestasis Of Pregnancy

Objective:To evaluate the predictive value of underlying parameters for prognosis of fetus and mothers and to investigate the relation between active management and prognosis in intrahepatic cholestasis of pregnancy (ICP).Methods: 396 patients with ICP cases reported from January 2002 to September 2007 were analyzed retrospectively,compared with 5968 cases pregnant women without ICP at the same time.Related risk factors of poor prognosis of the mother and fetus (including Early onset of ICP and high levels of serum bile acids,serum transaminase and bilirubin) and The relationship between the active clinic management of ICP and the prognosis of the mother and fetus was evaluated.Results:The incidence of meconium passage,neonatal asphyxia and prematurity were perfectly high in mothers whose serum transaminase,bilirubin and total serum bile acids(TBA) were higher and ICP started earlier. Active management of ICP and delivery by selective cesarean section in 36 to 38 weeks of gestation improve prognosis of fetus.Conclusion:Early onset of ICP and high levels of serum bile acids,serum transaminase and bilirubin predict poor fetus prognosis in ICP.Defining a subgroup of patients at risk for poor neonatal outcome and managing them actively ,the prognosis of fetus can be bettered by cesarean section in 36 to 38 weeks of gestation.