Clinical Analysis Of 106 Cases Of Liver Disease During Pregnancy On Maternal And Neonatal Outcomes

Objective:Analyze and summarize 106 cases of patients with liver disease during pregnancy,understanding of disease prognosis.Provide for the treatment of patients with liver disease in pregnancy and obstetric prognosis of clinical experience in order to better guide clinical work, thereby reducing adverse maternal and neonatal perinatal outcome of pregnancy rate.Methods:Collected from January 2012 to December 2015 in the Second Hospital of Jilin University childbirth maternal 106 cases of liver disease in pregnancy.Screening at birth the same period, the same age, and heart, liver and kidney function normal, healthy pregnant women, 50 cases of the control group.Exclusion criteria were: gestational diabetes, pregnant women with thyroid, cardiovascular and blood diseases and other pregnancy complications; twins, multiple births, ectopic pregnancy; pregnancy taking hormones, immunomodulators,etc; a history of other liver diseases(such as alcohol, fatty, toxic, autoimmune liver disease, etc.).Statistics different constituent ratio of liver disease during pregnancy,statistical analysis of two groups of pregnant women, adverse outcomes(death, postpartum hemorrhage, cesarean section) and birth outcomes(perinatal neonatal death, preterm birth, neonatal asphyxia, fetal distress).In particular statistical analysis of antihypertensive therapy effective and ineffective group maternal adverse birth outcomes,the patients were hypertensive disorders of pregnancy(HDP) with liver damage and concurrent HELLP syndrome.Statistics pregnant women with chronic HBV infection, anti-virus and no anti-viral treatment group maternal incidence of adverse outcomes.Results:106 patients were acute fatty liver of pregnancy(AFLP) 3 cases(2.83%), intrahepatic cholestasis syndrome(ICP) 10cases(9.43%), HDP 26 cases with liver damage(24.53%), HELLP syndrome in 24 cases(22.64%), 43 cases of pregnant women with viral hepatitis(40.57%), of which 38 cases with HBV infection(88.37%), HCV infection in 5 cases(11.63%).AFLP patients with postpartum hemorrhage, cesarean section, perinatal neonatal death, neonatal asphyxia, fetal distress incidence increased significantly(P <0.05);Comparison with the normal group,ICP are significantly higher in the cesarean section, prematurechildren,the incidence of fetal distress,there are significant differences(P <0.05);HDP hepatic damage with postpartum hemorrhage, cesarean section increased contrast with the normal group(P <0.05);HELLP syndrome comparing with the normal group,postpartum hemorrhage, cesarean delivery, fetal distress are significantly increased(P <0.05); Effective antihypertensive treatment group in postpartum hemorrhage, cesarean delivery, fetal distress and other adverse outcomes comparing with the incidence of ineffective antihypertensive treatment group is significantly decreased in HDP with hepatic impairment and HELLP syndrome.Pregnant women with viral hepatitis on maternal and perinatal adverse events, comparing with the control group, the difference is not statistically significant(P> 0.05), an oral anti-viral Ld T group comparing with no anti-viral treatment group, postpartum hemorrhage, decrease the incidence of cesarean births earlier, there are significant differences(P <0.05).Conclusion:Viral hepatitis in pregnant women with the highest incidence of liver disease during pregnancy.Women of childbearing age should be screened for hepatitis B two pairs of semi and HBV-DNA,pregnant women with chronic active HBV patients given active antiretroviral therapy will help to improve maternal and child adverse pregnancy outcomes.AFLP adverse outcomes for mother and child can have a serious impact,ti has a serious harm to the health of mother and child during pregnancy liver disease.ICP increase perinatal premature birth, fetal distress incidence, at the same time lead to higher rates of cesarean section.HDP hepatic damage in postpartum hemorrhage, cesarean section are increased,HELLP syndrome cause maternal postpartum hemorrhage, cesarean delivery, fetal distress rate increases,effective antihypertensive therapy can significantly improve the HDP with liver damage and HELLP syndrome incidence of maternal adverse outcomes.