The opportunity and the manner of delivery in female with intrahepatic cholestasis of pregnancy

Objective:To explore the opportunity and the manner of termination of pregnancy.Methods:The data of 200 cases of ICPfrom January 2007 to June 2008 were retrospectively analyzed.Maternal pruritis,liver function ,glycocholic acid(CG),amniotic fluid condition, the time and the way of termination of pregnancy,Apgar score were examined.Three groups were classified by the values of CG:Group A (CG1 000 μg/dl),GroupB(1 000 μg/dl≤CG3 000 μg/dl),and Group C(CG≥ 3 000 μg/dl). Results:The increased rates oftotal bilirubin alanine aminotransferase,aspartate aminotransferase,total bile aacid increased with the increase of the values of CG. There was no significant difference in the incidence of hypamnion. The incidence of meconium stained were statistically different. The gestational weeks of preterm delivery increased,with the increase of the values of CG,with the statistical different. The preterm delivery manner was statistically different.The higher CG,the higher cesarean section rate. The incidence of pruritus was statistically different,the higher CG, the mere severe pruritus. Conclusion:The guidelines for treatment of ICP introduced the assessment of serum values of CG in diagnostics as the most important indicator. When the disease is aggravate or to recur after treatment,delivery was recommended in the 32 th~34 th week when lung maturity had been established by using dexamethasone.Mostly patients of ICP labour in 37 weeks gestation delivery,when the values of CG was 3 000 μg/dl. The incidence of cesarean section was high.If the values of CG was1 000 μg/dl,vaginal delivery was feasible under careful monitoring.