Clinical analysis of 150 cases of early and middle pregnancy complicated with abnormal liver function
Objective:To investigate the etiology,treatment and therapeutic effect of patients with abnormal liver function in the early and middle trimester of pregnancy(before 28 weeks of gestation).Methods:From January 2022 to June 2023,the clinical data of 150 patients with abnormal liver function in the early and middle trimesters of the Second Hospital of Nanjing(the Affiliated Nanjing Hospital to Nanjing University of Chinese Medicine)were collected,and the gestational age,etiology,medication and outcome were analyzed retrospectively.Results:Among the 150 patients,33(22％)in early trimester(less than 14 weeks of gestation)and 117(78％)in middle trimester(14-27+6 weeks of gestation).Among them,there were 63 cases(42％)of pregnancy complicated with vi-ral hepatitis,20 cases(13.33％)of hyperemesis gravidarum,17 cases(11.33％)of drug-induced liver injury,3 cases(2％)of autoimmune liver disease,11 cases(7.33％)of gestational diabetes,5 cases(3.33％)of gestation-al hypertension.There were 14 cases(9.33％)with intrahepatic cholestasis during early pregnancy,10 cases(6.67％)with thyroid dysfunction,and 7 cases(4.67％)with unknown cause.For the patients with abnormal liv-er function and serum transaminase reaching 4 or more times the normal level,compound glycyrrhizin and glutathi-one were administered intravenously.Alanine aminotransferase(ALT)was(436.85±276.54)U·L-1 and aspar-tate aminotransferase(AST)was(312.39±147.85)U·L-1 before treatment.In 89 patients(59.33％),transam-inase decreased to normal(ALT≤40 U·L-1,AST≤35 U·L-1)at 2 weeks and pregnancy continued,13 patients(8.67％)embryo development stopped,and 3 patients(2％)were induced labor due to fetal death.5 cases(3.33％)had pregnancy termination for aggravated abnormal liver function,and 2 cases were transfered to ICU for further observation and treatment after pregnancy termination due to severe hepatitis,and the prognosis was good.Abnormal liver function recurred in 21 patients(14％)during the third trimester of pregnancy.Conclusion:The causes of abnormal liver function in the early and middle trimesters of pregnancy are various,viral hepatitis,drug hepatitis and hyperemesis gravidarum are common causes.In view of the etiology,the such pregnant women were treated by the use of safe and effective liver-protecting drugs,the effect is better.However,it does not rule out the progression of the disease,the occurrence of embryo stop development or fetal death in utero,and the possibility of medical termination of pregnancy.It is very important to pay attention to the liver function examination in the early and middle stages of pregnancy.
pregnancyearly and middle pregnancyabnormal liver functionliver protection drugs
万方数据
维普
