Received:15 January 2018,
Published:15 June 2018
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Fenglian XIAO, Yingru ZHENG. Relationship of total bile acid level and timing of termination with perinatal outcomes in intrahepatic cholestasis of pregnancy[J]. Journal of Third Military Medical University, 2018, 40(11): 1028-1032.
Fenglian XIAO, Yingru ZHENG. Relationship of total bile acid level and timing of termination with perinatal outcomes in intrahepatic cholestasis of pregnancy[J]. Journal of Third Military Medical University, 2018, 40(11): 1028-1032. DOI: 10.16016/j.1000-5404.201801128.
Objective
2
To determine the association of the perinatal outcomes with the level of total bile acid (TBA) and timing of termination in intrahepatic cholestasis of pregnancy (ICP).
Methods
2
A retrospective study was conducted among 198 women suffering from ICP treated in our hospital from March 2013 to June 2017. According to the level of TBA
the women were divided into 3 groups
that is
10~39.99 μmol/L (group Ⅰ)
40~99.99 μmol/L (group Ⅱ) and ≥100 μmol/L (group Ⅲ). On the basis of termination
the cases were also divided into 3 groups
<
36 weeks gestation (group A)
36~36
+6
weeks (group B)
and ≥37 weeks gestation (group C). The adverse perinatal outcomes of low birth weight
meconium-stained amniotic fluid (MSAF)
neonatal intensive care unit (NICU) admission
neonatal myocardial damage
pneumonia
hyperbilirubinemia
neonatal respiratory distress syndrome (NRDS) of perinatal infant were analyzed.
Results
2
The incidence of adverse perinatal outcomes in group ⅠA was significantly higher than those of groups ⅠB and ⅠC (
P
<
0.05). The incidence of low birth weight in group ⅠB was significantly higher than that in group ⅠC (
P
<
0.05). The incidence of NICU admission in group ⅠB was lower than that in group ⅠC
but without statistical difference (
P
>
0.05). The incidence of adverse perinatal outcomes in group ⅡA was notably higher than those in groups ⅡB and ⅡC (
P
<
0.05). The incidences of low birth weight and recent complications in group ⅡB were higher than those in group ⅡC
but there was no significant difference (
P
>
0.05). No newborns in groups ⅡB andⅡC entered in the NICU. The gestational age o
f onset in group Ⅲ was shorter than 34 weeks
and the incidence of adverse outcomes in the perinatal infants was higher when the gestational age was shorter than 36 weeks.
Conclusion
2
When serum TBA ranged from 10 to 40 μmol/L
termination of 37 weeks gestation is recommended to decrease the adverse perinatal outcomes of ICP
and when the range was 40~100 μmol/L
36 weeks gestation of termination is a strategy. While
for the women with TBA ≥100 μmol/L
termination should depend on maturation of the fetus.
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