| Abstract | Cilj: Utvrditi postoji li razlika u perinatalnom ishodu trudnoća kompliciranih kolestazom u odnosu na zdrave trudnoće.
Materijali i metode: U vremenskome razdoblju od 1. siječnja 2018. do 31. prosinca 2018. godine u KBC-u Split u Klinici za ženske bolesti i porode bilo je 4398 poroda. Analizirani su podatci 33 trudnice sa intrahepatalnom kolestazom u trudnoći i jednakog broja kontrola. Istraživani su parametri su: dob majke, trajanje trudnoće, porođajna masa i duljina, pH vrijednost umbilikalne arterije, zbroj po Apgarovoj, trofičnost i način dovršetka trudnoće.
Rezultati: Trudnice s intrahepatalnom kolestazom u trudnoći češće rađaju nedonošenu djecu i dovršavaju trudnoću carskim rezom. Prosječna starost majke u grupi slučajeva bila je 30,38±5,66 godina, u usporedbi s 30,36±5,87 godina u kontrolnoj skupini (P=0,751). U skupini trudnica s intrahepatalnom kolestazom u trudnoći devet (27,27%) je rodilo prijevremeno, a 24 u terminu (72,73%). U kontrolnoj skupini jedna je rodila prijevremeno (3,03%), a 32 u terminu (96,97%). Pronašli statistički značajnu razluku (P=0,006). Prosječna porođajna masa u grupi slučajeva bila je 3307,00±585,51 g i 3426,00 ±450 g u kontrolnoj skupini (P=0,358). Porođajna duljina bila je u prosjeku 49,88±2,37 cm u skupini s intrahepatalnom kolestazom u trudnoći i 50,55±2,31 cm u kontrolnoj skupini (P=0,251). Prosječni pH umbilikalne arterije kod novorođenčadi ispitivane skupine iznosio je 7,31±0,1 i 7,33±0,08 u kontrolnoj skupini (P=0,722). Broj rođene eutrofične djece u ispitivanoj iznosio je 25 (75,76%) u odnosu na 29 (87,88%) u kontrolnoj skupini, P=0,317. Jedno (3,03%) je novorođenče iz skupine sa intrahepatalnom kolestazom u trudnoći i troje (9,09%) rođenih u zdravoj skupini bilo hipotrofično. Broj hipertrofične djece u ispitivanoj bio je sedam (21,21%) u odnosu na jedno (3,03%) dijete kontrolne skupine. Statistički značajna razlika nije zabilježena između skupina (P=0,055). Sva je novorođenčadi majki s intrahepatalnom kolestazom u trudnoći imalo je Apgar ocjenu između 8 i 10 u odnosu na 32 (96,97%) novorođenčadi kontrolne skupine (P=0,5). 17 je žena iz skupine ispitanika imalo je vaginalni porod, a 16 je imalo operativni dovršetak trudnoće, dok je u kontrolnoj skupini 30 rodilo vaginalno i tri carskim rezom (P=0,001).
Zaključak: Retrospektivnim istraživanjem slučaja i kontrola nismo otkrili razliku u perinatalnom ishodu trudnoća kompliciranih kolestazom u odnosu na kontrolnu skupinu KBC-a Split. Trudnice s IKT-om češće rađaju nedonošenu djecu te trudnoću dovršavaju carskim rezom. |
| Abstract (english) | 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 4398 births that took place in the University hospital of Split in 2018., 33 identified pregnancies affected by obstetric cholestasis were compared to an equally sized control group regarding maternal epidemiology and perinatal outcome. Investigated parameters were: mothers’ age, pregnancy duration, fetal weight and length, umbilical cord blood pH, Apgar score, size for gestational age, delivery mode.
Results: The average maternal age of the case group was 30,38±5,66 years, compared to years 30,36±5,87 in the control group (P=0,751). In ICP group nine (27,27%) deliveries were preterm, 24 in term (72,73%). It was of statistical significance (P=0,006).Average fetal weight in the case group was 3307,00±585,51 g and 3426,00 ±450 g in the control group (P=0,358).Fetal length on average was 49,88±2,37 cm in the case group and 50,55±2,31 cm in the control group (P=0,251). The average umbilical cord blood pH in newborns of the ICP group was 7,31±0,1 and 7,33±0,08 in the control group (P=0,722) . Number of newborns small for gestatonal age in case group was 25 (75,76%) in comparison to 29 (87,88%) in control group (P=0,317). One (3,03%) newborn from intrahepatic cholestasis of pregnancy group and three (9,09%) in control group was small for gestational age (P=0,586). Number of newborns large for gestatonal age in case group was seven (21,21%) in comparison to one (3,03%) in control group (P=0,055). All newborns of mothers with intrahepatic cholestasis of pregnancy had an Apgar score between 8 and 10, while in healthy pregnancies 32 (96,97%) neonates achieved a score between 8 and 10 (P=0,5). Sewenteen women of the case group had a vaginal delivery and 16 underwent a Cesarean section, while in the control group 30 gave birth vaginally and three per C-section (P=0,001).
Conclusion: With this retrospective case control study we didn’t determinate any difference in perinatal outcome between pregnancies complicated by obstetric cholestasis to outcome of unaffected pregnancies in KBC Split. Pregnant women with ICP had more preterm newborns and also more Cesarian sections. |
