Clinical analysis of 42 cases of pregnancy complicated with severe hepatitis
10.3760/cma.j.issn.1008-6315.2014.09.020
- VernacularTitle:妊娠合并重症肝炎42例临床分析
- Author:
Ying FENG
- Publication Type:Journal Article
- Keywords:
Pregnancy;
Severe hepatitis;
Obstetric treatment;
Pregnancy outcome
- From:
Clinical Medicine of China
2014;30(9):961-963
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of pregnancy complicated severe hepatitis and summarize experience in diagnosis and treatment so as to decrease maternal mortality.Methods Forty-two cases of pregnant women with severe hepatitis in the hospital were retrospectively analyzed.According to the outcome,all subjects were divided into death group(27 cased) and survival group(15 cases).Clinical data including viral markers,clinical manifestations,blood biochemistry,clinical treatment and pregnancy outcomes were recorded.Results (1) Pathogen examination showed that the major infection was hepatitis B virus (HBV),accounting for 64.29％ (27/42).(2) The first symptoms was gastrointestinal symptoms,accounting for 73.81％ (31/42).(3) The level of serum albumin,cholesterin (CH) and cholinesterase (CHE) in survival group were (29.91 ± 6.78) g/L,(2.80 ± 1.02) μmol/L and (5 399.4 ± 1 096.5) U/L respectively,significantly higher than that in death group((25.14 ± 7.36) g/L,(1.73 ± 0.77) μmol/L,(3423.6 ± 1102.7) U/L respectively).The serum creatinine(SCr) and prothrombin time (PT) levels in survival group were (83.06 ± 47.23) μ mol/L,(18.98 ± 6.72) s,lower than that in death group ((231.54 ± 58.90) μmol/L,(44.16 ± 5.38) s).The differences were statistically significant (t =2.07,3.84,5.57,8.37,13.29 ; P ＜ 0.05 or P ＜ 0.001).(4) The mortality rate of patients who chose pregnancy termination was 31.58％ (6/19),lower than the overall average mortality rate 64.29％ (27/42) and the difference was statistically significant (x2 =5.636,P =0.018).Conclusion HBV infection is the main reason for pregnant women with severe hepatitis.Gastrointestinal symptoms is the main symptom.Serum albumin,SCr,PT,serum CH and CHE can be regarded as prognostic indicators of the disease.Active comprehensive treatment and timely pregnancy termination can reduce maternal mortality.
