小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 除面部以外的瘙痒
- 不伴皮疹的皮肤抓痕
其他诊断因素
- 轻度黄疸
危险因素
- 妊娠期肝内胆汁淤积症 (ICP) 既往病史
- 丙型肝炎病史
- 妊娠期肝内胆汁淤积症家族史
- 年龄 > 35 岁
- 多胎妊娠
诊断性检查
首要检查
- 胆汁酸
- 肝功能检查 (LFT)
- 凝血指标
- 空腹状态下血清胆固醇
- 丙型肝炎病毒学
需考虑的检查
- 肝脏活检
治疗流程
具有症状的轻型（胆汁酸小于 40 µmol/L）
重型（胆汁酸大于等于 40 µmol/L）+ 孕周小于 37 周
重型（胆汁酸大于等于40 µmol/L）+ 孕周大于等于 37 周
撰稿人
作者
Robert H. Debbs, DO, FACOOG
Associate Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine
University of Pennsylvania School of Medicine
Director
Pennsylvania Hospital Maternal Fetal Medicine Network
Philadelphia
PA
利益声明
RHD declares that he has no competing interests.
鸣谢
Dr Robert H. Debbs would like to gratefully acknowledge Dr Derek Jurus, a previous contributor to this monograph. DJ declares that he has no competing interests.
同行评议者
Frank Lammert, MD
Director
Department of Internal Medicine II
Professor Internal Medicine
Saarland University Hospital
Homburg
Germany
利益声明
FL declares that he has no competing interests.
Ron Librizzi, DO, FACOOG
Director
Maternal Fetal Medicine
Virtua Health System
Associate Professor of Obstetrics and Gynecology
Thomas Jefferson University School of Medicine
Philadelphia
PA
利益声明
RL declares that he has no competing interests.
Vincenzo Berghella, MD, FACOG
Director
Maternal Fetal Medicine
Professor
Obstetrics and Gynecology
Thomas Jefferson University School of Medicine
Philadelphia
PA
利益声明
VB declares that he has no competing interests.
鉴别诊断
- 急性肝炎
- HELLP 综合征
- 急性妊娠期脂肪肝
更多 鉴别诊断指南
- 肝脏疾病与妊娠
- 产科胆汁淤积症
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