| Abstract | Cilj: Otkriti ima li intrahepatična kolestaza u trudnoći loš utjecaj na perinatalni ishod u
jednoplodnim trudnoćama u KBC-u Split u dvogodišnjem razdoblju.
Ispitanici i postupci: U razdoblju od 1. siječnja 2021. godine do 31. prosinca 2022. godine u
KBC-u Split izdvojena je 41 rodilja s IKT.om i jednoplodnom trudnoćom te je izdvojen isti broj
kontrola i ukupan broj sudionica bio je 82. Promatrani su parametri paritet trudnica, dob trudnica
u godinama, trajanje trudnoće u tjednima računatim po posljednjem danu zadnje menstruacije,
način dovršetka trudnoće (carski rez ili vaginalni porod), Apgar zbroj u 5. minuti, porodna masa u
gramima, porodna duljina u centimetrima, trofičnost novorođenčeta te prijemi novorođenčadi na
jedinice intenzivnog liječenja.
Rezultati: Broj fetalnih smrti u obje skupine iznosio je 0. Prosječna dob trudnica u skupini
kolestaze bila je 31,4±3,62, a u kontrolnoj skupini 32,29±5,18 godina. Nismo pronašli statistički
značajnu razliku (P=0,186). U skupini trudnica sa intrahepatičnom kolestazom 7 ih je rodilo
prijevremeno, a 34 u terminu dok su u kontrolnoj skupini 3 žene rodile prijevremeno, a 38 njih u
terminu te nismo pronašli statistički značajnu razliku (P=0,177). Učestalost poroda carskim rezom
u skupini rodilja sa intrahepatičnom kolestazom bila je 60,97%, dok je u kontrolnoj skupini
učestalost bila 26,83% te smo pronašli statistički značajnu razliku (P=0,002). Broj novorođenčadi
sa Apgar zbrojem od 8-10 u 5 minuti u obje skupine bio je 39, a po 2 novorođenčeta iz svake
skupine imala su Apgar zbrojeve u 5. minuti ≤ 7 te nismo pronašli statistički značajnu razliku među
skupinama (P=1,000). Prosječna porođajna masa novorođenčadi iz skupine trudnica s IKT-om
iznosila je 3398,20±463,51 gram, a prosječna porođajna duljina u toj skupini bila je 49,61±1,83
cm. U kontrolnoj skupini prosječna porođajna masa novorođenčadi bila je 3578,80±643,39 grama,
a prosječna duljina 50,12±3,07 cm. Nismo pronašli značajnu razliku (P=0,074, P=0,180). U obje
skupine broj eutrofične novorođenčadi bio je 30 te statistički značajna razlika nije pronađena
(P=0,389). Broj djece iz skupine majki s IKT-om koji je završio na jedinicama intenzivnog
liječenja bio je 16, a broj djece iz kontrolne skupine bio je 15 te nije pronađena statistički značajna
razlika (P=0,820).
Zaključak: U promatranom dvogodišnjem razdoblju IKT u jednoplodnim trudnoćama nije bio
povezan sa lošijim perinatalnim ishodima i trudnoća je češće dovršavana carskim rezom. |
| Abstract (english) | Objective: To determine whether intrahepatic cholestasis of pregnancy (ICP) has a negative
impact on perinatal outcomes in singleton pregnancies at the Clinical Hospital Center Split during
a two-year period.
Materials and methods: From January 1, 2021, to December 31, 2022, 41 pregnant women with
ICP and singleton pregnancies were selected at the Clinical Hospital Center Split, along with an
equal number of controls, resulting in a total of 82 participants. Parameters observed included the
parity of pregnant women, age of pregnant women in years, gestational age in weeks calculated
from the last day of the last menstrual period, mode of delivery (cesarean section or vaginal
delivery), Apgar score at 5 minutes, birth weight in grams, birth length in centimeters, newborn
trophicity, and admissions of newborns to intensive care units.
Results: The number of perinatal deaths and meconium staining of amniotic fluid in both groups
was 0. The average age of pregnant women in the cholestasis group was 31.4±3.62 years, while in
the control group, it was 32.29±5.18 years. No statistically significant difference was found
(P=0.186). No statistically significant difference was found (P=0.177) in the rate of premature
birth. The frequency of cesarean section deliveries in the group of women with intrahepatic
cholestasis was 60.97%, while in the control group, the frequency was 26.83%. A statistically
significant difference was found (P=0.002). The number of newborns with Apgar scores of 8-10
at 5 minutes was 39 in both groups, and 2 infants from each group had Apgar scores ≤ 7 at 5
minutes. No statistically significant difference was found between the groups (P=1.000). No
significant difference was found in birth weights and hights of infants (P=0.074, P=0.180). In both
groups, the number of eutrophic newborns was 30, and no statistically significant difference was
found (P=0.389). The number of children from the ICP group who required intensive care unit
admission was 16, while the number of children from the control group was 15. No statistically
significant difference was found (P=0.820).
Conslusion: In the observed two-year period, ICP in singleton pregnancies was not associated
with worse perinatal outcomes, and cesarean section deliveries were more frequent. |
