[The maternal-fetal harm study of intrahepatic cholestasis of pregnancy]

The aim of this study was to assess the harm of intrahepatic cholestasis of pregnancy (ICP) to the mother and fetus. The symptoms, liver function and outcome of 471 cases of ICP in our hospital during 1989-1996 were studied retrospectively. The mean pregnant weeks when pruritus first came on was 32.4 +/- 4.7 (12-40) weeks, the incidence of preterm delivery 16.6% (78 cases); the perinatal mortality 12.7@1000 (6 cases). The incidence of the cases associated with amnion fluid II degree-III degree (n = 108) was 24.2%. The relationship between the mode of delivery (natural labor = 1, forceps delivery = 2, cesarean section = 3) and newborn Apgar scores was positive (r = 0.1188, P < 0.05). The amniotic fluid status in the group of 30-33(+6) pregnant weeks was significantly worse than that in the group of term pregnancy (0.89 +/- 1.11 vs 0.55 +/- 0.96, P < 0.05). The amniotic fluid status in the group with serum total bilirubin > 34 mumol/L was worse than that in the 17.1-34 mumol/L group (0.96 +/- 1.1 vs 0.65 +/- 1.04, P < 0.05), and that in the group with serum total bile acid concentration > 40 mumol/L was worse than that in the serum total bile acid normal group (< or = 20 mumol/L) (0.89 +/- 1.1 vs 0.33 +/- 0.8, P < 0.05). Our results suggest that the severity of ICP may be indicated by early onset of pruritus (30-36(+6) pregnant weeks), the rising of serum total bilirubin level and the increasing of total bile acid concentration, and based on these indicators, timely cesarean section may increase the newborn Apgar scores.