Clinical Study Of 85 Cases Of Pregnancy With Thrombocytopenia

Objective: To investigate the cause and thrombocytopenia in pregnancy on pregnancy outcome and perinatal treatment,in order to provide theoretical basis and practical guidance for more health care during pregnancy and perinatal treatment of thrombocytopenia in pregnancy,to reduce maternal and perinatal mortality.Methods: a retrospective analysis of Anhui Provincial Hospital from 2008 to 2014 years of term delivery of 85 cases of pregnancy with thrombocytopenia in patients with clinical data,85 patients had no other complications of pregnancy,and the exclusion of drug-induced thrombocytopenia.Laboratory examination at least 3 times,the blood test indicated that the platelet was less than 100 * 109/L.All patients in the study group were divided into group GT,group ITP and other causes according to the cause of disease.Records of maternal age,gravidity,thrombocytopenia etiology,clinical manifestations,complications,results of laboratory examination including blood routine,coagulation function,bone marrow,mode of delivery,postpartum hemorrhage,neonatal outcome index.The etiological factors,clinical manifestations,laboratory indexes,pregnancy outcomes and perinatal treatment were analyzed and compared among the subgroups.85 pregnant women who had normal platelet count were selected as the control group.The mode of delivery,the incidence of postpartum hemorrhage and the neonatal condition were compared between the study group and the control group.Results: thrombocytopenia(gestational,thrombocytopenia,GT)occurred in 69 cases(81.2%)in pregnant women with thrombocytopenia,all cases First occurrence were pregnant 20~28 week.Idiopathic thrombocytopenic purpura in 10 cases(11.7%),in addition to 6 cases diagnosed before pregnancy,the other 4 cases for 20 weeks before the start of pregnancy,and in pregnancy and perinatal diagnosis.Other causes of thrombocytopenia in 6 cases(7.1%),including systemic lupus erythematosus (Systemic lupus red plaques,SLE)and 2 cases of aplastic anemia(Aplastic anemia,AA)in 3 cases and 1cases of preeclampsia,6 cases are not standardized.In GT,58 cases were spontaneous delivery,11 cases were cesarean section,3 cases were spontaneous delivery in ITP,7 cases were cesarean section,4 cases were caused by other causes of thrombocytopenia,2 cases were spontaneous delivery,and nineteen cases were cesarean section.Postpartum hemorrhage group GT 4 cases(5.7%),group ITP 4 cases(40%),other etiological group 2 cases(33.3%).Other cases of etiology were lack of standardized examination and corresponding treatment during pregnancy.They were diagnosed in the late pregnancy,delivery and post partum follow-up.Some GT group and ITP group were treated with vitamin C,blood raising agent and glucocorticoid orally during pregnancy,without platelet transfusion.In the control group,70 cases were spontaneous delivery,15 cases were cesarean section,1 cases were posterior bleeding(1.2%).No intracranial hemorrhage occurred in the study group and the control group.Conclusion: most of the thrombocytopenia associated with pregnancy is mainly GT,followed by ITP.Other causes of thrombocytopenia(including systemic lupus erythematosus,aplastic anemia etal.)rare.Severe thrombocytopenia is more common in ITP and other pathological thrombocytopenia.The mode of delivery in pregnancy associated with thrombocytopenia depends on platelet level,primary disease,and obstetric factors.The rate of cesarean section and the rate of postpartum hemorrhage increased in severe thrombocytopenia patients.We should strictly screen out pathological factors,strengthen standardized diagnosis and treatment,and strengthen postpartum follow-up to avoid the misdiagnosis of pathological thrombocytopenia.