妊娠合并血小板减少的原因及其对母婴预后的影响

Causes of Pregnancy Combined with Thrombopenia and Effect on the Maternal and Infant Prognosis

目的探讨妊娠合并血小板减少(PT)的原因及其对母婴预后的影响。方法 2015年12月—2017年12月间将盐城市第一人民医院收治的75例PT产妇作为研究对象,依据血小板计数分为A、B、C、D 4组。对4组产妇病因进行分析,并观察产妇及新生儿预后情况。结果病因构成比例从高到低依次为PAT、PHD、ITP、AA、系统性红斑狼疮、病因不明。4组妊娠期高血压疾病、早产及产后出血发生率对比,差异有统计学意义(χ~2=13.398、8.966、15.160,P<0.05);A组孕周(36.13±3.22)周、B组孕周(37.05±1.74)周、C组孕周(36.82±2.88)周、D组孕周(36.47±4.73)周,4组分娩周数对比,差异无统计学意义(F=1.483,P>0.05);4组贫血、产褥感染发生情况对比,差异无统计学意义(χ~2=2.246、3.012,P>0.05)。围生儿血小板减少出现20例,颅内出血3例,足月低体重儿4例,未出现死亡病例,4组颅内出血及足月低体重儿率对比,差异无统计学意义(χ~2=5.481、4.639,P>0.05);4组新生儿血小板减少发生率对比,差异有统计学意义(χ~2=9.454,P<0.05)。结论 PAT、PHD、ITP、AA、系统性红斑狼疮、病因不明等均可引发PT,将增加母体妊娠期高血压疾病、贫血、产后出血、产褥感染等发生风险,易引发早产、新生儿血小板减少等不良母婴结局,因此临床应给予充分重视。

Objective To study the causes of pregnancy combined with thrombopenia and effect on the maternal and infant prognosis. Methods From December 2015 to December 2017 75 cases of PT delivery women admitted and treat- ed in our hospital were selected and divided into four groups according to the causes of the four groups, and the prog- nosis of delivery women and newborns was observed. Results The ratio of causes from high to low was respectively PAT, PHD, ITP, AA, systemic lupus etTthematosus, etiology unknown, and the differences in the hypertension, and in- cidence rates of premature delivery and postpartum hemorrhage between the two groups were stalistically significant （X2=13.398,8.966,15.160, P〈0.05） , and the pregnancy week in the group A, group B, group C and group D was respec- tively （36.13±3.22） weeks, （37.05±1.74） weeks, （36.82±2.88） weeks and （36.47±4.73） weeks, and the difference was not statistically significant, （F=1.483, P〉 0.05） , and the difference in the occurrence of anemia, puerperal infection be- tween the four groups was not statistically significant （χ2=2.246, 3.012, P〉0.05） , and there were 20 cases with throm bopenia, 3 cases with intracranial hemorrhage, 4 full term low weight infants, and 0 case died, and the differences in the intracranial hemon＇hage and low birth weight infant between the four groups were not statistically significant （χ2= 5.481, 4.639, P〉 0.05） , and the difference in the incidence rate of thrombocytopenia of the newborns between the four groups was statistically significant （χ2=9.454, P〈0.05） . Conclusion The PAT, PHD, ITP, AA, systemic lupus etythe matosus, etiology unknown can cause the PT, which can increase the occurrence risks of maternal pregnancy induced hypertension, anemia, postpartum hemorrhage, puerperal infection, and it is easy to cause the premature delivery, thrombocytopenia of the newborns and other adverse maternal and infant outcomes, therefore, we should give full atten-tion in clinic.