A Analysis Of The End Of Pregnancy And Fetus With Heavy Viral Hepatitis

Viral hepatitis is one of the common clinical infectious diseases, pregnantwomen especially easy infection during pregnancy. Pregnancy liver burden, fetalwithin the mother of growth and the process of delivery and often aggravating liverdamage, can lead to liver cell large necrotic cause severe hepatitis, maternal and fetusto all cause serious adverse effects. Yet there is no effective can be assessed diseaseprognosis of the method, often occur in patients have missed the best treatmentopportunity. Therefore, understanding the matrix and the fetus may affect theoutcome of the general risk factors and treatment process condition monitoring andevaluation, and has great clinical significance and social significance.ChapterⅠPreliminary discussion pregnancy with viral hepatitis to thepregnant women and the fetus end effects-pregnancy with viralhepatitis201cases clinical analysis【Objective】Preliminary discussion pregnancy with viral hepatitis to the pregnant women andthe fetus end effects. 【Method】Collect records in our observation treatment of201cases of pregnancy with viralhepatitis patients (hepatitis group), at the same time, and no health select cyclecomplications of pregnant women200(not hepatitis group) as control group, thecomparative analysis between two groups of pregnant women and the fetus endadverse outcome.【Result】Hepatitis group cases, etiology mainly related to hepatitis b virus infection, therewere157cases,78.1%(157/201), the incidence of fulminant hepatitis is14.6%(23/157); Hepatitis group of30cases of maternal mortality, a fatality rate of14.9%,all for patients with severe hepatitis. The control group no deaths; Hepatitis groupascites, hepatic encephalopathy, infection, electrolyte imbalance, bleeding tendency,hepatorenal syndrome (HRS), dic significantly higher than the complications such ashepatitis group, and group cases of hepatitis complication occurred mainly frompatients with severe hepatitis; The hepatitis group happened without abortion,stillbirth, with maternal death, fetal adverse outcome, only12cases of premature birth,and all live. Hepatitis group of abortion, stillbirth, premature birth, death, with thematrix was higher than the group such as hepatitis, and mainly from patients withsevere hepatitis.【Conclusion】Pregnancy with viral hepatitis patients, pregnancy liver burden, maternalphysiology change, fetal within the mother of growth and the process of delivery andoften aggravating liver damage, its quite part may develop into heavy-duty hepatitis,maternal and fetus to cause serious adverse effects. So profound understanding to thepregnancy with viral hepatitis, especially pregnancy with heavy viral hepatitis toimproving the pregnant women and the fetus is particularly important to the outcome. ChapterⅡTo further explore pregnancy with heavy viral hepatitis clinicaland fetus prognostic factors analysis result【Objective】Through the64cases of pregnancy with heavy viral hepatitis of clinical datawere analyzed, preliminary understanding of the pregnant woman and the influence ofthe fetus turned over general risk factors and the significance of the conditionmonitoring and evaluation, and for effective pregnancy with heavy viral hepatitis andprovided the clinical guidance, reduce the mortality of pregnant women and fetus.【Method】In64cases of pregnancy with heavy viral hepatitis patients,34patients get betterfor improving group cases,30deaths for death group. The control study, patients withclinical data were analyzed retrospectively. Data to mean±standard deviation said,two groups of mean differences between compares the t test and inspection or rank,count material using a chi-square test, single factor analysis with many factors withunconditional Logistic regression analysis.【Result】In may affect the pregnancy with heavy viral hepatitis general related factors,pregnant women age, pregnant women, the degree of education, professional womeninfected by maternal type and etiology types and pregnant women was notsignificantly associated risk of death; Gestational age at the late period of pregnancycomplications, the more advanced disease, more anxious, bravery-enzyme separationphenomenon is obvious and hepatic b to exceed the results indicated that the narrow,pregnant women risk of death increases, and have the regular regularly for theconsciousness in childbirth and use the cesarean section, pregnant women lower riskof death. In the treatment of monitoring the process of illness change, ALT, AST,ALT/AST, ratio of GLB, A/G, CHE, TBIL, DBIL, TBA, NH3, improving group and the differences between the way death test was not statistically significant (P>0.05);PT, PTA, TP, ALB, CHOL, the WBC, AFP, Scr, GLU, Ca+comparison, testedstatistically significant difference (P<0.05).In this study information of64cases ofpregnancy with heavy viral hepatitis in pregnant women, were64cases of patientswith conceived the fetus,28cases of death, live in36cases, fetal total mortality was43.8%(28/64), fetal premature to give priority to, accounted for48.4%(31/64).Hepatitis b HBV related infections as many as71.88%(46/64). Maternal hepatitis bgroup, conceived fetal46cases of death in23cases, live25cases (among them7cases of fetal childbirth death, before the fetus in the matrix after cesarean sectionlive), fetal mortality was50%(23/46); The matrix of hepatitis b group, conceivedfetal18cases,5cases died, live in13, fetal mortality was27.8%(5/18), two groups offetal end to compare the test had statistically significant (P <0.05).【Conclusion】Gestational age at the late period of pregnancy complications, the more advanceddisease, more anxious, bravery-enzyme separation phenomenon is obvious andhepatic B to exceed the results indicated that the narrow, pregnant women risk ofdeath increases, and have the regular regularly for the consciousness in childbirth anduse the cesarean section, pregnant women lower risk of death. Appear hepaticencephalopathy IV period, hepatorenal syndrome (HRS), DIC, hepaticencephalopathy, bleeding tendency, infection, electrolyte imbalance, ascitescomplications, such as increased risk of death, and the higher the risk of thecomplications. CHOL <2.9mmol/L, ALB <30g/L, TBIL>350umol/L, PTA <20%,GLU <2.8mmol/L, Ca+<2.03mmol/L examination results are the poor prognosisindex.