Analysis Of Clinical Characteristics Of 146 Cases Of Pregnancy-specific Liver Disease

Objective:1.Normal pregnant women and patients with ICP were selected as the research objects to analyze the biochemical indicators of ICP patients and the incidence of adverse perinatal outcomes.According to the total bile acid level,the ICP patients were divided into two groups,comparing the changes of their biochemical indicators,to explore the risk factors that affected the adverse perinatal outcome.2.To analyze the clinical characteristics of patients with HELLP(hemolysis,elevated liver enzymes and low platelets)syndrome,the incidence of adverse perinatal outcomes and related factors of maternal and infant adverse outcomes.Methods:Retrospective analysis:1.From January 2017 to December 2020,the clinical data of82 pregnant women with intrahepatic stasis of pregnancy(as ICP group)diagnosed by obstetrics in our hospital were collected,and 84 healthy pregnant women enrolled from hospital in the same period were taken as control group.The biochemical indicators of two groups were detected by automatic biochemical analyzer,including the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),γ-Glutamyltranspeptidase(γ-GGT),total bile acid(TBA)and alkaline phosphatase(ALP)in serum.The ICP patients were further divided into 65 persons in mild ICP group(10umol/L≤TBA<40umol/L)and 17 in severe ICP group(TBA≥40umol/L)according to the level of TBA.The related indictors and fetal outcomes of each group were analyzed and compared by statistical method.2.In this period,it is also collected that the clinical data of 64 patients with HELLP syndrome in our hospital,were divided into two groups:partial HELLP syndrome group(A group)and complete HELLP syndrome group(B group).The general condition,laboratory test results,perinatal information and pregnancy outcome of the two groups were recorded respectively.Results:1.Compared with control group,the levels of serum ALT,AST,TBIL,DBIL,γ-GG T,ALP in ICP group were significantly higher.The level of serum ALT 252.90(123.40,374.3)U/L,AST 217.65(99.10,276.50)U/L,TBIL 21.00(15.65,48.85)umol/L,DBIL 7.60(4.47,20.00)umol/L,γ-GGT 32.00(26.62,51.80)U/L,ALP 328.00(206.45,460.00)U/L in severe ICP group were significantly higher than those of mild ICP group:ALT 49.70(19.75,145.50)U/L,AST 49.70(29.25,107.40)U/L,TBIL 15.40(8.65,23.90)umol/L,DBIL 3.50(1.35,7.35)umol/L,γ-GGT 14.40(8.40,32.80)U/L,ALP 187.60(133.80,259.50)U/L(p<0.05).The incidence of adverse outcomes(35.37%)in ICP group were higher than those in control group(14.29%)(p<0.05).Binary logistic regression analysis showed that A LT(OR=1.018),TBIL(OR=1.088),DBIL(OR=0.851),TBA(OR=1.061)were independent r isk factors for fetal adverse outcomes(p<0.05).2.The levels of platelet count(PLT)(82.79±53.88)×10~9/L,direct bilirubinin(DBIL)3.20(1.33,9.13)umol/L patients with com plete HELLP syndrome(group B)were significantly lower to partial HELLP syndro me group(group A)(115.00±59.31)×10~9/L,11.80(1.15,3.00)umol/L.Serum lactate dehy drogenase(LDH)828.45(658.50,1115.63)U/L,ALT 68.20(34.65,65.10)U/L,AST 99.45(74.25,180.35)U/L,TBIL 19.25(9.13,29.40)umol/L,DBIL 3.20(1.33,9.13)umol/L in patient s with group B increased significantly than LDH 534.50(336.00,758.75)U/L,ALT 34.95(12.68,56.15)U/L,AST 43.60(22.43,78.25)U/L,TBIL 10.35(6.90,15.75)umol/L,DBIL 1.80(1.15,3.00)umol/L during patients of group A(p<0.05).The incidence of maternal complication in patients with group B(96.40%)increased significantly than group A(80.60%)(p>0.05).There were no significant differences in delivery method and fet al outcomes between two groups(p>0.05).Onset gestational(30.35±4.01)week of ad verse maternal and infant outcome group were significantly earlier than normal grou p(36.67±2.78)week(p<0.05).The onset of gestational age of onset is correlated with adverse maternal and infant outcomes.Conclusion:1.The biochemical indicators of ICP patients are significantly abnormal,and the incidence of adverse fetal outcomes is higher than that of normal patients.2.In serum ALT,TBIL,DBIL,TBA levels are independent risk factors for predicting the occurrence of adverse fetal outcomes in ICP patients.3.Clinical HELLP syndrome are complex,so early detection and early diagnosis can terminate pregnancy in time and improve maternal and infant the adverse outcomes.