Objective: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disorders. Although various biological effects of corticotrophin-releasing hormone (CRH) has in pregnancy have been reported, its activities in patients with ICP are lacking. Here we evaluated CRH and its receptor (CRH-R1) expression in placenta and serum in control and ICP patients, to assess their potential activities in the ICP pathogenesis. Methods and materials: Placental tissues were obtained from the control and ICP patients (10 cases for each group) between 37 and 39 gestational weeks. Immunohistochemistry, Western Blotting and realtime PCR analysis were used to detect the CRH and CRH-R1 expression in placenta. Meanwhile, maternal serums were analyzed for detecting CRH in the control and ICP patients (80 cases for each group) in 34e37 gestational weeks. All data were observed and recorded for comparing and analyzing in control and ICP patients. Results: CRH staining was found in syncytiotrophoblast and feto-placental vascular endothelium cells of placenta, whereas CRH-R1 staining was found in syncytiotrophoblast by using immunohistochemical analysis. The CRH expression level in ICP placenta was significantly lower than those results in controls (P < 0.01). For CRH-R1, CRH mRNA and CRH-R1 mRNA expressions, no statistical differences were found between control and ICP groups (all P > 0.05). Serum CRH levels increased in both control and ICP groups, but the growth rate was limited in ICP group, especially in late pregnancy (P < 0.05). Conclusions: The down-regulation of CRH in ICP placentas and the limited growth rate of CRH in the maternal serum of ICP patients might impair the blood flow regulation of the utero-placental-fetal unit, which might result in poor fetoplacental vascular perfusion and adverse pregnancy outcomes. CRH might play a significant role in the pathogenesis of ICP and provide a new approach to further investigate the etiology of ICP.

[目的]探讨母婴血型不合孕妇孕期管理、妊娠结局及其影响因素。[方法]对住院分娩的40例母婴血型不合溶血病的孕产妇及新生儿临床资料进行回顾性分析。[结果]母婴ABO血型不合溶血病37例(92.5%),母体ABO血型抗体抗-A或B(IgG)不同效价之间,新生儿脐血改良直接抗人球蛋白试验(改良Coombs试验)阳性反应及新生儿黄疸发生时间有差异(P﹤0.05),母血抗-A或B(IgG)效价1︰128共14例(37.84%),其新生儿脐血改良Coombs试验阳性反应及24h新生儿黄疸发生明显增加;孕妇ABO血型抗体滴度与新生儿外周血间接胆红素水平呈正相关(P﹤0.05)。母婴Rh血型不合溶血病3例(7.5%),母体Rh血型抗体效价均≥1︰512,最高达1︰1024,新生儿均接受了换血治疗。[结论]夫妇ABO血型不同的O型孕妇,母体ABO血型抗体效价≥1︰128时发生新生儿溶血病的风险明显增加;夫妇Rh血型不同的Rh(D)阴性孕妇,应加强孕期Rh血型抗体等监护及产前产后胎婴儿观察和处理。建议在对孕妇进行血型鉴定时,同时筛查ABO血型抗体及ABO外抗体。

目的 观察妊娠肝内胆汁淤积症(ICP)胎盘小叶绒毛血管系统的体视学变化。方法随机选择于37～40周择期剖宫产终止妊娠的ICP与正常妊娠各10例,采用体视学方法测定胎盘小叶绒毛血管的容积及横切面积。结果 ICP组患者胎盘小叶绒毛血管容积〔(203.63±41.29)mL〕较正常组〔(287.81±69.81)mL〕下降约29%、血管横切面积〔(485087.6±104707.63)μm2 vs.(617119.5±158422.65)μm2〕下降约21%,其中含平滑肌绒毛血管容积〔(55.98±21.08)mL vs.(131.98±84.68)mL〕、横切面积〔(127576.2±54897.44)μm2 vs.(271809.6±162354.35)μm2〕下降明显(P<0.05),无平滑肌绒毛血管容积〔(155.91±30.52)mL vs.(161.48±75.80)mL〕、横切面积〔(341849.3±57043.88)μm2 vs.(342639.6±145717.51)μm2〕无明显下降(P>0.05);绒毛血管数量〔(365.20±96.73)vs.(313.4...