| Objective:Thrombocytopenia is a common pregnancy complication caused by various diseases, and the most common cause is gestational thrombocytopenia (GT). This study is on GT's clinical manifestation, laboratory examination, and clinical treatment. It also discusses maternal and infant prognosis, in order to make an early diagnosis and avoid unnecessary intervention and treatment.Methods:Make a retrospective analysis from January 2009 to December 2010 on 87 cases of gestational thrombocytopenia patients for clinical data. According to the platelet count these cases can be divided into two groups:group A platelet count> 50 x 109/L, and group B platelet count<50×109/L. (1 Statistically summarized the clinical manifestations including gums bleeding, nose bleeding, skin mucous and membrane petechial hemorrhages (2) Statistically summarized GT patients'laboratory tests such as routine blood, blood coagulation series, anemia series, bone marrow like in order to observe thrombocytopenia degree, the platelet form abnormalities, abnormal activated partial thromboplastin time (APTT), abnormal prothrombin time (PT), merger anemia, and abnormal manifestation of bone marrow. (3) Compared two groups clinical treatment before childbirth:including platelet infusion, oral litres of platelet medicine use and hormone therapy. (4) Compared different influences on postpartum hemorrhage made by delivery method and platelet count. (5) Compared neonate's outcome: summarize GT group for neonatal thrombocytopenia and bleeding. Compared neonate's outcome between group A and group B. Compared neonate's outcome between GT group and normal group. (6) Compared the platelet count between antenatal and 3 days after childbirth, and follow-up to postpartum six weeks.Result:(1) The clinical manifestations of GT patients:there were 4 cases with clinical hemorrhage symptoms (2) Laboratory tests:there were 56 cases whose platelet counts≥50×109/L, which accounted for 64.37%.The platelet form of GT group compared with normal control group was not statistically significant. Clotting series were all in the normal range. According to the blood tests, anemia series, bone marrow piercing,37 cases were diagnosed as anemia, which taked 42.53% of GT. Bone marrow of 10 cases showed no abnormal performance about giant nuclear department. (3) Two groups'clinical treatment before childbirth:group A had 7 cases needed platelet infusion and 3 cases needed drug therapy, while group B had 25 cases needed platelet infusion and 9 cases needed drug therapy。The difference were both statistically significant (P<0.05). (4) The influences on postpartum hemorrhage made by delivery method and platelet count:39 cases made vaginal delivery with an average bleeding of 273.08±12.16ml, and 48 cases made cesarean delivery with an average bleeding of 275±14.43ml. The difference was not statistically significant (P>0.05).Group A made an average bleeding of 252.68±10.38ml, and group B made 309.68±7.87ml. The difference was statistically significant (P<0.05). (5) The neonate's outcome:There were two cases of newborn in GT group not full-termed because of tire premature rupture of membrane (36+3w,36+5w), and the others were all full-termed. There was no intracranial bleeding or other bleeding happened and adopted 11 newborns umbilical cord blood platelet count test showed normal. Group A and group B's comparison of neonatal outcome:group A had an average score of 9.21±0.81 points, and group B 9.29±0.16 points. The difference was not statistically significant (P>0.05). The newborn s average weight was 3157.93±63.82 g in group A, and 3046.93±65.53 g in group B. The difference was not statistically significant (P>0.05).The comparison between GT group and normal group in neonatal outcome:GT group had an average score of 9.23±0.066 points, and the normal group 9.33±0.087 points. The difference was not statistically significant (P>0.05). The newborn's average weight was 3119.27±47.55 g in the thrombocytopenia group, and 3206.83±57.74 g in the normal group. The difference was not statistically significant (P>0.05). (6)The comparison of the platelet count between antenatal and 3 days after childbirth:all the two groups were statistically significant difference (P<0.05).The follow-up investigation of postpartum 6 weeks showed that78 cases' platelet count returned to normal spontaneously.Conclusion:(1) GT showed less hemorrhage symptom in clinical.It was generally mild-to-moderate thrombocytopenia with normal platelet form and normal coagulant function, and bone marrow like giant nuclear was normal, but usually complicated with anemia. (2)The clinical treatment depended on its hemorrhage tendency and platelet count.The lower the platelet count is, the more likely clinical treatment needs. (3) Different delivery modes made little impact on the postpartum hemorrhage, while different platelet count influenced it.(4)The thrombocytopenia's degree didn't affect neonatal outcomes including Apgar score and birth weight. (5)The platelet count increased significantly after delivery, and it returned to normal in postpartum six weeks in general. |
PDF Full Text Request