关键词: 胆汁淤积, 肝内, 胆汁酸类和盐类, 胎儿窘迫, 呼吸窘迫综合征, 新生儿, 妊娠期肝内胆汁淤积症

Abstract: Intrahepatic cholestasis of pregnancy is characterized with unexplained pruritus，elevated concentration of total bile acid and liver transaminases，which are influenced by abnormal hormone level in the second or third trimester，gene mutation，immune injury and increased release of pruritogens. Although it has good prognosis on pregnant women，it plays an important role on increased risk of adverse fetal outcomes，including preterm delivery，fetal distress，fetal mortality and neonatal respiratory distress syndrome. The abnormal metabolism of steroids and elevated total bile acid increase myometrial sensitivity for oxytocin and promote cervical ripening so as to induce premature delivery. Bile acid desposition in the placenta leads to spasm of placental villous vessels and decreasing placental reserve capacity. Also，bile acid accumulation can play a toxin role on fetal heart and lung，resulting in cardiac conduction dysfunction and reduced synthesis of pulmonary surfactant. All these contribute to increased rate of fetal distress，fetal death and neonatal lung injury.

Key words: Cholestasis, intrahepatic, Bile acids and salts, Fetal distress, Respiratory distress syndrome, newborn