妊娠合并地中海贫血的临床分析

Clinical Analysis on Mediterranean Anemia in Pregnancy

目的:探讨妊娠合并地中海贫血的筛查方法及其临床意义。方法:选择2002年至2006年在本院系统产前检查并住院分娩的孕妇资料5438例,回顾性分析妊娠合并地中海贫血的筛查方法及妊娠结局的差异。结果:①5438例孕妇中,正常对照组4768例,非地贫组358例,地贫组312例。②地贫组312例,占5.7%,该组孕妇的红细胞平均体积(MCV)及红细胞平均血红蛋白含量(MCH)均明显低于对照组和非地贫组,差异有极显著性(P<0.01)。③地贫组和非地贫组的异常妊娠发生率明显高于对照组,差异有极显著性(P<0.01)。④地贫组和非地贫组的剖宫产率及早产率明显高于对照组,差异有显著性(P<0.05)。⑤3组新生儿体重的平均值无显著性差异(P>0.05)。结论:①建议首次产前检查的孕妇均做血常规检查,MCV、MCH值可作为妊娠合并地中海贫血筛查的指征。②如果仅孕妇一方为地中海贫血患者,可以妊娠至足月并分娩,但胎儿宫内生长发育会受到一定程度的不利影响。③如果夫妇双方携带了相同类型的地贫基因,建议做产前诊断,如果确诊为重型地贫胎儿,建议终止妊娠。

Objective： To study the screening methods and clinical significance of Mediterranean anemia in pregnancy. Method： To make a retrospective analysis on the screening methods of Mediterranean anemia in pregnancy and differences of pregnant outcome based on the 5,438 cases of pregnant women＇ s data those were made systematic prenatal check - up and gave hospital delivery during 2002 - 2006 at our hospital. Re- sult： ① Among the 5,438 cases of pregnant women, there are 4,768 cases of normal control group, 358 ca- ses of non - Mediterranean anemia group, and 312 cases of Mediterranean anemia group. ② 312 cases of Mediterranean anemia group accounts for 5.7%. MCV and MCH of this group of pregnant women are obvi- ously lower than those of the normal control group and non - Mediterranean anemia group with a remarkable difference （ P 〈0.01 ）. ③ The incidence rate of abnormal pregnancy of Mediterranean anemia group and non - Mediterranean anemia group is obviously higher than that of the normal control group with a remarkable difference （P 〈0.01 ）. ④The rate of cesarean section and premature birth incidence rate of Mediterranean anemia group and non - Mediterranean anemia group is obviously higher than that of the normal control group with a markable difference （ P 〈 0.05 ）. ⑤Weight of able difference （ P 〉 0.05 ）. Conclusion： ① Blood the newborn of the 3 groups are with no obvious mark- routine examination is recommended for the pregnantwomen who make the prenatal check, up for the first time. The value of MCV and MCH may serve as the demand for screening of Mediterranean anemia in pregnancy. ② If only the pregnant woman is ill with Medi- terranean anemia, full term pregnancy and delivery are possible. But disadvantage affection against the growth and development of the fetus in uterus may be caused in. ③ If both of the husband and wife are with the same kind of Mediterranean anemia gene, prenatal diagnosis is recommended. If with the diagnostic re- suit of a severe Mediterranean anemia fetus, termination of pregnancy is recommended.