妊娠合并血小板减少症的病因学分析及其对母儿结局的影响
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[摘要] 目的 观察妊娠期血小板减少症的病因及其对母儿结局的影响。 方法 回顾性分析我院收治的妊娠期血小板减少病例64例，根据孕期最低血小板计数分成四组。Ⅰ组：（50～100）X 109/L；Ⅱ组：（30～50）×109/L；Ⅲ组：（10～30）×109/L；Ⅳ组：
[关键词] 妊娠并发症；血小板减少；妊娠结局；病因学
[中图分类号] R714 [文献标识码] A [文章编号] 1673-7210（2012）08（c）-0071-03
Etilolgy analysis of pregnancies complicated with thrombocytopenia and its influence to outcomes of pregnant woman and infant
ZHANG Huizhen
Department of Gynaecology and Obstetrics, the Central Hospital of Xianyang City, Shaanxi Province, Xianyang 712000, China
[Abstract] Objective To observe the effect of gestational thrombocytopenia on outcome of pregnancy and the etiology of pregnancies complicated with thrombocytopenia. Methods The Clinical data of 64 pregnant women with thrombocytopenia were analyzed retrospectively． According to the minimal level of platelets in pregnancy, the patients were divided into 4 groups: group Ⅰ [platelets count was (50-100)×109/L, n=20]；group Ⅱ [platelets count was (30-50)×109/L, n=16]；group Ⅲ[platelets count was (10-30)×109/L, n = 15]；group Ⅳ[platelets count was (0-10)×109/L, n=13]. The etiology of pregnancies complicated with thrombocytopenia, demographic data such as pregnancy complications，treatment and outcomes of the patients in each group were analyzed. Results The major complications of pregnant women with thrombocytopenia were pregnancy associated thrombocytopenia (PAT), hypertensive disorder complicating pregnancy (HDCP) and idiopathic thrombocytopenic purpura (ITP), and PAT about 45.3%, which was the major cause of pregnant women with thrombocytopenia. Medical complications in pregnancy and puerperium of these patients were HDCP, anemia, preterm delivery, postpartum hemorrhage and puerperal infection. With the aggravation of thrombocytopenia, the morbidity of anemia, preterm delivery and postpartum hemorrhage were increasing. There were significant differences in the morbidity among the four groups (P < 0.05), and the morbidity of thrombocytopenia of neonatus increased with the aggravation of thrombocytopenia of their mother (P < 0.05). Conclusion The etiology of pregnancies complicated with thrombocytopenia is complex. With the aggravation of thrombocytopenia in pregnancy, the risk of anemia，premature delivery, postpartum hemorrhage and neonatal thrombocytopenia are increasing. While the perinatal outcomes may be improved with the close perinatal care.