Clinical Analysis Of 169 Cases Of Pregnant Patients With Thrombocytopenia

Objective:we retrospective analysis the clinical data of patients with pregnancy combined with thrombocytopenia,in order to study the effect of thrombocytopenia on the prognosis of maternal and infant outcomes.Methods:We collect the information of 169 pregnancy complicated thrombocytopenia,who were admitted to Ningbo First Hospital from January 2017 to December2018,then we analyze the different causes of thrombocytopenia and the degree of thrombocytopenia caused by thrombocytopenia.Analyze the different causes of thrombocytopenia and then compare thrombocytopenia on the mode of delivery,postpartum hemorrhage,the rate of postpartum hemorrhage,intervention methods during delivery,maternal and neonatal outcome and postpartum platelet recovery.Results:We included a total of 169 pregnant patients with thrombocytopenia,and then divided the 169 patients into 3 groups according to the reduction of platelet(PLT):Group A:mild PLT(50～100)×10~9/L,106 patients;Group B:Moderate PLT(30～50)×10~9/L,50 patients;Group C:Severe PLT less than 30×10~9/L,13 patients.According to the clinical causes of pregnancy thrombocytopenia,there are divided into four groups:Group I is a patient with thrombocytopenia during pregnancy,a total of 103 patients;Group II is a patient with hypertension-related diseases during pregnancy,including:severe preeclampsia,HELLP syndrome,Acute fatty liver,a total of 29 patients;Group III patients with hematological diseases,a total of 15patients;IV is thrombocytopenia caused by other reasons,including:maternal immune diseases,infections,drug-related diseases,etc,a total of 22 patients.In addition,we found 60 patients of vaginal delivery,109 patients of cesarean delivery,47 patients of vaginal delivery in group A,the rate of cesarean section was 56.66%;11 patients of vaginal delivery in group B,78%of cesarean section,vaginal delivery in group C,the cesarean section rate was 84.62%,and the difference in cesarean section rate between the three groups was statistically significant(P<0.05);the amount of bleeding during delivery between the three groups of A,B,and C was 328.77±171.96ml in group A;438.46±256.70ml in group B,475.00±320.28ml in group C,the difference was statistically significant(P<0.05),and the group C had the most bleeding during delivery;platelet transfusion between the three groups of A,B,and C was 15 patients;28 patients;10 patients,among which C The number of patients receiving platelet transfusion during labor increased,and the difference between the three groups was statistically significant(P<0.05);the postpartum hemorrhage rate,use of uterine contraction drugs,neonatal thrombocytopenia,neonatal mortality and newborns among the three groups of A,B,and C,There was no statistically significant bleeding in neonatal(all P>0.05).according to the etiology,and then comparing the amount of bleeding during delivery between groups,we found that patients in groupⅡ(patients with hypertension-related diseases during pregnancy)had more than other groups,and the difference was statistically significant(P<0.05);In addition,the difference in platelet recovery between 42 days and 3 months postpartum was statistically significant(P<0.05).Hence,patients in groupⅢ(hematological disease group)still need to continue treatment and intervention after delivery.Conclusion:1.The common causes of pregnancy with thrombocytopenia are thrombocytopenia during pregnancy,hypertension-related diseases during pregnancy,hematological diseases,immune system diseases,and unexplained thrombocytopenia;2.Hypertension during pregnancy and severe thrombocytopenia group(PLT less than 30×10~9/L)is likely to cause an increase in the amount of bleeding during delivery,and requires active intervention,mainly based on symptomatic treatment of platelet transfusion;patients with thrombocytopenia caused by hematological diseases still need continuous treatment after delivery;3.For thrombocytopenia after reasonable treatment,the effect on the outcome of maternal and neonatal is not significant.Termination of pregnancy in time according to the condition will greatly reduce the mortality of maternal and neonatal and improve pregnancy outcomes.