| Sažetak | Objective: To determine whether there is a difference in the perinatal outcome in pregnancies complicated by intrahepatic cholestasis compared to unaffected pregnancies.
Materials and methods: Out of 2466 births that took place in the University Hospital of Split in 2016, 28 identified pregnancies affected by obstetric cholestasis were compared to an equally sized control group regarding maternal epidemiology and perinatal outcome. Included into the control group was every birth recorded consecutive to a case of with parity equal to that case. Investigated parameters were the mothers’ age, maternal BMI, pregnancy duration, fetal weight, fetal length, Apgar score, umbilical cord blood pH, delivery mode and size for gestational age.
Results: There was no statistically significant difference in the observed variables in pregnancies affected and not affected by intrahepatic cholestasis. The average maternal age of the case group was 30.25±4.07 years, compared to 30.43±4.66 years in the control group (p=0.879). Mothers with ICP had an average BMI of 22.86±2.58, those without had one of 23.53±4.99 (p=0.535). Pregnancy lasted 37 weeks or longer in 89.29% of cases of ICP, shorter than that in 10.71%, compared to the control group where 96% of pregnancies lasted at least 37 weeks and 3.57% lasted shorter (p=0.118). Average fetal weight in the case group was 3493.57±551.75g and 3373.21±517.02g in the control group (p=0.403). Fetal length on average was 50.39±1.97cm in the case group and 49.75±2.01cm in the control group (p=0.232). 92.86% of babies of mothers with ICP had an Apgar score between 8 and 10 and 7.14% had one between 4 and 7, while after healthy pregnancies all neonates achieved a score between 8 and 10 (p=0.118). The average umbilical cord blood pH in newborns of the ICP group was 7.32±0.09 and 7.34±0.07 in the control group (p=0.431). 78.57% of women of the case group had a vaginal delivery and 21.43% underwent a Cesarean section, while in the control group 64.29% gave birth vaginally and 35.71% per C-section (0.235). No newborn of the ICP group and 7.41% of the ones born to healthy group were SGA (p=0.142), 89.29% in the case group and 85.19% in the control group were AGA (p=0.648), and 10.71% of neonates in the group with cholestasis were LGA compared to 7.41% in the group without cholestasis (p=0.670).
Conclusion: There is no difference in perinatal outcome between normal pregnancies and pregnancies complicated by intrahepatic cholestasis in the University Hospital of Split. |
| Sažetak (hrvatski) | Cilj: Odrediti da li postoji razlika u perinatalnom ishodu u trudnoćama sa intrahepatičnom kolestazom u usporedbi sa trudnoćama van utjecaja intrahepatične kolestaze.
Materijali i metode: Od 2466 porođaja koji su se dogodili u KBC-u Split u 2016. godini, 28 identificiranih trudnoća pod utjecajem intrahepatične kolestaze uspoređene su sa kontrolnom skupinom iste veličine u vezi epidemioloških karakteristika majki i perinatalnog ishoda. U kontrolnoj skupini je uključen svaki porod dokumentiran uzastopno slučaju intrahepatične kolestaze sa paritetom jednakim tom slučaju. Istraženi parametri su bili dob majke, BMI majke, trajanje trudnoće, porodna težina, porodna duljina, Apgar zbroj, pH krvi pupačne vrpce, način rođenja i trofičnost djece.
Rezultati: Nije bilo značajnih razlika u istraženim varijablama u trudnoćama sa intrahepatičnom kolestazom u usporedbi sa trudnoćama bez intrahepatične kolestaze. Prosječna dob majka u ispitivanoj skupini je bio 30,25±4,07 godina, u usporedbi sa 30,43 ±4,66 godina u kontrolnoj skupini (p=0,879). Majke sa kolestazom su imali prosječan BMI od 22,86±2,58, one bez kolestaze od 23,53±4,99 (p=0,535).Trudnoća je trajala 37 tjedana ili duže u 89,29% slučaja kolestaze, kraće od toga u 10,71%, u usporedbi sa kontrolnom skupinom u kojoj 96% trudnoća je trajalo barem 37 tjedana i 3,57% je trajalo kraće (p=0,118). Prosječna porodna težina u ispitivanoj skupini je bila 3493,57±551,75g i 3373,21±517,02g je bila u kontrolnoj skupini (p=0,403). Porodna duljina u prosjeku je bila 50,39±1,97cm u ispitivanoj skupini i 49,75±2,01cm u kontrolnoj skupini (p=0,232). 92,86% novorođenčadi majki sa intrahepatičnom kolestazom je imalo Apgar zbroj od 8 do 10 i 7,14% od 4 do 7, ali poslije zdravih trudnoća sva novorođenčad je postigla zbroj između 8 i 10 (p=0,118). Prosječan pH krvi pupačne vrpce u novorođenčadi od skupine sa kolestazom je bio 7,32±0,09, i 7,34±0,07 je bio u kontrolnoj skupini (p=0,431). 78,57% žena u ispitivanoj skupini su rodile vaginalno i 21,43% su se podvrgnule carskom rezu, dok u kontrolnoj skupini 64,29% su imale vaginalni porod i 35,71% carski rez (p=0,235). Nijedno novorođenče iz skupine sa kolestazom i 7,41% onih rođenih u zdravoj skupini nije bilo hipotrofično (p=0,142), 89,29% u ispitivanoj skupini i 85,19% u kontrolnoj skupini su bili eutrofični ( p=0,648), i 10,71% novorođenčadi u skupini sa kolestazom su bili hipertrofični u usporedbi sa 7,41% u skupini bez kolestaze (p=0,670).
Zaključak: Ne postoji razlika perinatalnog ishoda između normalnih trudnoća i trudnoća kompliciranih sa intrahepatičnom kolestazom u KBC-u Split. |
