孕妇血栓前状态对胎儿生长受限与新生儿结局的影响分析

Analysis of impact of prethrombotic state of pregnant women on fetal growth restriction and neonatal outcome

目的探讨孕妇血栓前状态对胎儿生长受限与新生儿结局的影响。方法 40例存在胎儿受限情况且没有合并症的产妇随机分为观察1组(低分子肝素治疗)和观察2组(不接受低分子肝素治疗),各20例。同期38例给予常规治疗的正常分娩产妇作为对照组,对观察组与对照组新生儿情况进行观察和对比。结果孕32周,观察1组血小板计数(PLT)为(184.32±46.11)×10~9个/L低于对照组的(246.45±39.24)×10~9个/L,差异具有统计学意义(P<0.05)。孕36周,观察1组凝血酶原时间(PT)为(10.58±0.78)s高于对照组的(9.97±0.78)s,差异具有统计学意义(P<0.05)。生产前各组凝血功能指标比较,差异无统计学意义(P>0.05)。对照组新生儿体重明显高于观察1组和观察2组,观察1组新生儿体重高于观察2组,差异具有统计学意义(P<0.05);但各组出生胎龄比较,差异无统计学意义(P>0.05)。结论胎儿生长受限产妇血栓前状态于孕32周前已出现,使得胎儿宫内发育迟缓,出生体重降低;低分子肝素能改变胎儿生长受限产妇血栓前状态,对新生儿结局进行改变。

Objective To explore the impact of prethrombotic state of pregnant women on fetal growth restriction and neonatal outcome.Methods A total of40pregnant women with fetal growth restriction and non complications were randomly divided into observation group A(received low molecular heparin treatment)and observation group B(received non low molecular heparin treatment),with2cases in each group.Concurrent38normal labor pregnant women receiving conventional therapy were named as control group.Neonatal statuses in observation group and control group were observed and compared.Results At32weeks ofgestation,the observation group A had lower blood platelet count(PLT)as(184.32±46.11)×109pieces/L than(246.45±39.24)×109pieces/L in the control group,and the difference had statistical significance(P<0.05).At36weeks of gestation,the observation group A had higher prothrombin time(PT)as(10.58±0.78)s than(9.97±0.78)s in the control group,and the difference had statistical significance(P<0.05).All groups had nostatistically significant difference in coagulative function indexes before delivery(P>0.05).The control group hadhigher neonatal weight than observation group A and observation group B,and observation group A had higherneonatal weight than observation group B.Their difference had statistical significance(P<0.05).All groups hadno statistically significant difference in gestational age(P>0.05).Conclusion Prethrombotic state of pregnant women with fetal growth restriction appeared before32weeks of gestation,and it delays fetus intrauterine growth and lower birth weight.Low molecular heparin can change prethrombotic state of pregnant women with fetal growth restriction,so as to change neonatal outcome.