Prospective Study Of 325 Cases Of Thrombocytopenia In Pregnancy And Its Effect On Maternal And Foetal Outcome

Objective:To investigate the causes of thrombocytopenia in pregnancy,the peripartal management and perinatal outcomes,for clinical provides the basis of the research.Methods:We evaluated platelet counts throughout pregnancy in women who delivered at Shanghai Jiao Tong University Affiliated Sixth People’s Hospital between 1st January 2009 and 31st December 2019.The diagnosis of thrombocytopenia in pregnancy was the blood platelet counts lower than 100x10~9/L twice in pregnancy.325 cases of pregnant women were analyzed retrospectively.Then they were divided into 3 groups according to blood platelet count during pregnancy:mild group(≥50×10~9/L),moderate group(30×10~9/L-50×10~9/L),severe group(<30×10~9/L).Patients combined with ITP were divided into 4 groups according to management:group A(general treatment such as Yixuesheng capsules or peanut clothes);group B(glucocorticoid treatment group);group C(IVIG treatment group);group D(glucocorticoid and IVIG treatment group)Globulin therapy group).Record the maternal pregnancy and delivery outcomes,as well as postpartum platelet values and other indicators.The database was established by Excel software,and statistical analysis was performed using SPSS 22.0 software.P<0.05 indicated that the difference was statistically significant.Results:1.From 1st January 2009 and 31st December 2019,a total of 325 pregnancies in thrombocytopenia occurred,accounting for 9.32‰(325/35210)of the total number of deliveries in the same period.150 cases in mild group,87 cases in moderate group,88 cases in severe group.2.Compared with mild,moderate and severe groups,there was no statistically significant difference in the age of the pregnant women in each group(P>0.05);Hospital length of stay,premature birth rate and cesarean section rate in the severe group were lower than those in the mild and moderate groups(P<0.05).Severe group components of gestational weeks and neonatal birth weight were significantly lower than the other groups(P<0.05).The probability of prenatal bleeding and neonatal asphyxia in the moderate and severe groups was significantly higher than that in the mild group(P<0.05).3.Among 61 pregnant women with immune thrombocytopenia,the treatment effect of the severe group was 78.79%;the treatment effect of special treatment(glucocorticoid and/or IVIG treatment)was 81.82%.Conclusion:Severe thrombocytopenia is associated with increased risk of prolonged hospital length of stay,prenatal bleeding,premature delivery,increased cesarean section rate,low birth weight of the newborn,and neonatal asphyxia;glucocorticoids treatment,IVIG treatment,or a combination of both,increase platelet count in pregnancy with thrombocytopenia within a short period of time.