Clinic Study Of Pregnancy Associated Thrombocytopenia

Objective: To investigate the thrombin function and platelet function of pregnancy associated thrombocytopenia (PAT) women, and the correlation between platelet count and postpartum hemorrhage , and perinatal outcome.Methods: The clinical information of 41 cases of PAT women who delivered in our hospital within May 2006 to August 2006 were analysed prospectively. The thrombin function, the platelet function , the volume of bleeding in delivery, the occurrence rate of postpartum hemorrhage, and the birth weight of the newborns were included. All PAT women were divided into 3 groups as below: Group 1 with PLT between 80×109/L to 99×109/L, Group 2 with PLT between 50×109/L to 79×109/L, and Group 3 with PLT below 50×109/L.①The values of prothrombin time (PT) and the activated partial thromboplastin time (APTT) were compared among Group 1, Group 2, Group 3 and Control. The correlation between the thrombin function and the platelet count was also analysed.②The abnormity rates of platelet function were compared among the four groups.③The patterns of delivery, the volume of bleeding in labor and the occurrence rate of postpartum hemorrhage among four groups were also compared.④The perinatal outcome, which including the Apgar score, the premature delivery and the birth weight of the newborns were analysed among four groups.Result: 1.Comparison of PT and APTT between normal pregnant women and PAT women:①The PT values of Group 1 ,Group 2, Group 3 and Control were 10.79±0.45 s, 11.19±0.48 s,11.00±0.47 s,and 11.19±0.53 s respectively. There were no significant differences among the four groups(p>0.05).The APTT values of Group 1, Group 2, Group 3 and Control were 28.44±4.33 s , 27.65±4.33 s, 29.43±4.55 s , and 27.83±4.07 s respectively . There were no significant differences among the four groups either(p>0.05).②The coefficient of correlation (r) between PT and PLT was 0.14(p>0.05), between APTT and PLT was -0.07(p>0.05).2.The abnormity rates of platelet aggregation test of Group 1, Group 2, Group 3 and Control Group were 11.8%,13.3%,11.1%, and 8.3% respectively. There were no significant differences among the four groups by the Row×Column chi-squate test(p>0.05).3.The volumes of bleeding in different patterns of delivery were investigated.①The volumes of bleeding of Group 1-vaginal delivery Group, Group 1-Cesarean delivery Group , Group 2-Caesarean delivery Group, Group 3-Caesarean delivery Group , Control Group-vaginal delivery Group and Control Group-Caesarean delivery Group were(225.00±106.07)ml,( 214.00±66.63 ) ml, ( 227.33±94.07 ) ml, ( 338.89±126.93 ) ml,(200.00±54.77)ml, and(241.67±73.60)ml respectively. There was no significant difference between Group 1-vaginal delivery Group and Control Group-vaginal delivery Group(p>0.05).There were significant differences(p=0.0149)among the four caesarean delivery groups. In addition, the differences among Group 3 and other groups were significant, and the differences among the rest groups were not significant.②The coefficient of correlation (r) between the volume of bleeding in caesarean section and the PLT value was -0.16(p>0.05).4.There were no significant differences among the four groups when comparing the occurrence rates of postpartum hemorrhage (p>0.05).5.The neonatal birth weights among the four groups were compared.①The neonatal birth weight of Group 1, Group 2 , Group 3 and Control Group were(3252.06±372.18)g,(3362.67±411.95)g,(3200.56±274.91)g,and(3452.08±351.27)g respectively. There were no significant differences among the four groups(p>0.05).②The coefficient of correlation (r) between the weight of the newborns and PLT was 0.18(p>0.05).Conclusions: The thrombin function and platelet function of the PAT women were not affected by the platelet count . The risks of postpartum hemorrhage in mild PAT and middle-grade PAT were not higher than in normal pregnant women, but severe PAT women had higher risk of postpartum hemorrhage. The perinatal outcome of PAT women which including the Apgar score, the premature delivery and the neonatal birth weight were not affected by the platelet count either.