摘要
Abstract
Objective:To investigate the etiology,clinical characteristics,diagnosis and treatment plans,maternal and infant outcomes of thrombocytopenia during pregnancy,so as to provide an effective basis for early clinical accurate identification and personalized treatment.Methods:The clinical data of 255 pregnant women with thrombocytopenia who delivered in the obstetrics department of the First Affiliated Hospital of Zhengzhou University from June 2019 to June 2023 were collected.According to the etiology,they were classified as pregnancy-associat-ed thrombocytopenia(PAT),hypertensive disorder complicating pregnancy(HDCP),idiopath-ic thrombocytopenic purpura(ITP)and other groups.The degree of thrombocytopenia,clinical characteristics,treatment options and maternal and infant outcomes were compared among the groups.Results:The main causes of thrombocytopenia during pregnancy were PAT,ITP and HDCP,and other causes were rare.There was no significant difference in the number of preg-nancies and births and body mass index among the four groups(P>0.05).The age of ITP group was lower than that of other three groups,the severe group was younger than the mild group,with statistically significant differences(P<0.05).The thrombocytopenia in PAT group and HDCP group was mainly mild,and the proportion of severe thrombocytopenia in ITP group and other groups was higher(P<0.05).There were more bleeding events,blood transfusion during pregnancy and other therapeutic measures in ITP group than in the other three groups,and the difference among all groups was statistically significant(P<0.05).According to differ-ent grouping methods,the coagulation reaction time(R)of the PAT group was the lowest in the group,and the coagulation angle(α),maximum amplitude(MA)of ITP group and mild group were the highest in each group.The severe group were opposite to the above,and the difference was statistically significant(P<0.05).Compared with the other three groups,the maternal and infant outcomes in the PAT group were the best.The ITP group had the highest cesarean section rate due to thrombocytopenia,bleeding events and the proportion of platelet transfusion during hospitalization,and the largest amount of blood loss during delivery and during operation.Pre-term birth rate and Apgar score in HDCP group were the lowest,and the differences among all groups were statistically significant(P<0.05).Conclusion:The causes of thrombocytopenia during pregnancy are different.The degree of thrombocytopenia,clinical characteristics and ma-ternal and infant outcomes are different.The onset symptoms of PAT patients are insidious,the degree of thrombocytopenia is mild,and the occurrence time is late.Patients with primary im-mune thrombocytopenia have early detection time,more bleeding events,and severe thrombocy-topenia,the HDCP is in between.Timely identification of the cause and reasonable standardized treatment are the key to improving maternal and infant outcomes.关键词
妊娠期血小板减少/病因分类/临床特点/母婴结局Key words
Thrombocytopenia during pregnancy/Etiological classification/Clinical characteristics/Maternal and infant outcomes分类
医药卫生
