Maternal-fetal Outcomes Analysis Of Pregnancy With Thrombocytopenia

Objective: Analyze the clinical data of pregnancy with thrombocytopenia,to explore the onset time,coagulation function,mode of delivery,maternal and neonatal outcome and postpartum recovery in the different causes and degrees of thrombocytopenia.Methods: Collected 171 patients whoes PLT less than 100 * 109 / L at least 2 times in gestational period to study.patients were divided into 4 groups according to pathogeny: group I(Gestational thrombocytopenia group)101cases,group II(pregnancy hypertensive disorder complicating group)51cases,group III(idiopathic thrombocytopenic purpura group)28cases,group IV(Other causes group)14cases.The patients of non-pregnancy hypertensive associated thrombocytopenia were divided into 3 groups according to severity : group A(mild): 50*109/L< PLT <100*109 /L),67cases;group B(moderote): 30*109/L< PLT < 50*109 /L,17cases;group C(severe): PLT <30*109/L,36 cases.Analyze general condition,onset time,coagulation function,mode of delivery,intrapartum hemorrhage,postpartum recovery,maternal and neonatal outcome in different groups.Results: The delivery rate of PT in our hospital was 3.70% in the years of 2016.There was a total of 171 cases,of which 45.61% were GT,29.82% were pregnancy hypertensive associated thrombocytopenia,16.37% were ITP and 8.19% were other types of PT.The PT?PT-INR?APTT?FIB had no statistically significant among group I,II,III and IV(p>0.05),The TT and D-Dimer had statistically significant among group I,II,III and IV(p<0.05),the TT and D-Dimer in group II were higher than group I,III and IV.The intrapartum hemorrhage had statistically significant among group I,II,III and IV(p<0.05),the intrapartum hemorrhage in group II were higher than group I,III and IV.the rate of postpartum haemorrhage had no statistically significant among group I,II,III and IV(p>0.05),The rates of moderate to severe anemia,fetal death,premature delivery,postpartum recovery,hematologist treatment,neonatal asphyxia,neonatal thrombocytopenia,neonatology treatment and neonatal death had statistically significant among group I,II,III and IV(p<0.05).the rate of moderate to severe anemia in group IV were higher than group I,IIand III.the rate of fetal death,premature delivery,neonatal asphyxia,neonatology treatment and neonatal death in group II were higher than group I,III and IV.the rate of neonatal thrombocytopenia in group III were higher than group I,IIand IV.the rate of postpartum recovery in group I,II were higher than group IIIand IV.the rate of hematologist treatment in group IIIand IVwere higher than group I and II.The PT,PT-INR,APTT,FIB,TT,D-Dimer and intrapartum hemorrhage had no statistically significant among group A,B,C(p>0.05),.The rates of cesarean section for thrombocytopenia had statistically significant among group A,B,C(p<0.05),the rates of cesarean section for thrombocytopenia group A higher than group C.The rates of postpartum haemorrhage,fetal death,premature delivery,neonatal asphyxia,neonatal thrombocytopenia,neonatology treatment had no statistically significant among group A,B,C(p>0.05),The rates of moderate to severe anemia,hematologist treatment,premature delivery had statistically significant among group A,B,C(p<0.05),the rate of moderate to severe anemia,hematologist treatment in group C were higher than group A.the rate of postpartum recovery in group A were higher than group B and C.Conclusion:1.The commom causes of PT were GT,HELLP syndrome,severe preeclampsia,ITP,AA,SLE.2.The PT had a great impact to mother and fetus,strengthening the management of pregnancy and multidisciplinary cooperation.3.The patients of pregnancy hypertension associated thrombocytopenia with coagulation abnormalities,increased the risk of bleeding.4.The delivery mode of PT would comprehensive assessment based on platelet values,coagulation function,and other obstetric aspects.5.Strengthening the monitoring of neonatal,monitoring of neonatal blood platelet,Preventing the bleeding events of neonatal.