妊娠合并血小板减少性疾病27例临床分析

Analysis of Thrombocytopenia in Pregnancy 27 Cases

目的 探讨妊娠合并血小板减少性疾病孕妇分娩前后的处理方法及其对母婴预后的影响。方法 对 2 7例妊娠合并再生障碍性贫血、血小板减少性紫癜、白血病的孕妇的临床资料进行回顾性分析。结果 13例孕妇在孕期多次输血纠正贫血和提升血小板 ,9例产前给予大剂量糖皮质激素 ,2 7例均剖宫产分娩。 19例发生产后出血 ,2例发生DIC而死亡。 3例合并脑出血者 2例痊愈 ,1例因DIC死亡。新生儿出生体重 2 10 0～ 36 5 0g ,平均 3130g ,其中 3例为早产儿 ,Apgar评分 10分者 2 2例 ,轻度窒息者 3例 ,重度窒息者 2例 ,新生儿死亡 2例 ,均为早产儿。结论 加强围产期保健和血小板减少性疾病的治疗 。

Objective To observe the perinatal management and outcomes of the puerpera and neonatus with thrombocytopenia in pregnancy. Methods 27 cases of thrombocytopenia in pregnancy were retrospectively analyzed with their clinical practice. Results 13 cases received blood transfusions to elevate the platelets and treat anemia during pregnancy.9 cases took large doses of glucocorticoid hormone. All of 27 women were performed cesarean delivery. There were 19 cases of postpartum hemorrage,2 cases of disseminated intravascular coagulation(DIC) which led to maternal death.Among 3 women with intracranial hemorrhage, 2 of them survived while the other one died of DIC. Neonatal birth weight ranged from 2100g-3650g with the average of 3130g. 3 were premature newborn. Apgar scores were respectively: 10 scores 22 cases,Shght asphyxia 3 cases,severe asphyxia 2 cases. Both neonatal deaths were premature. Conclusion We should enhance the health care and therapy during the perinatal period to improve the maternal and neonatal survival rate.