Clinical Significance Of HB,HCT And Three Items Of Cagulation In Early Spontaneous Abortion

?Objective?Early spontaneous abortion refers to the loss of natural pregnancy which occurs 12 weeks ago.It is one of the common diseases in women of childbearing age,which seriously endangers women's reproductive health and mental health.Studies have shown that hemoglobin(HB)and hematocrit(HCT)are associated with early spontaneous abortion,and the imbalance of coagulation-anticoagulation-fibrinolysis system is one of the important mechanisms of early spontaneous abortion.The purpose of this study is to understand the changes and significance of HB,HCT and three items of coagulation by comparing the three indexes of normal early pregnancy and early spontaneous abortion.?Materials and methods?A total of 275 patients were selected from the gynecology and obstetrics clinic of the third affiliated Hospital of Guangzhou Medical University from June,2016 to March 2020 because of "missed abortion,inevitable abortion and incomplete abortion".Another 300 normal early pregnant patients who need artificial abortion operation were treated in the gynecology and obstetrics clinic of the third affiliated Hospital of Guangzhou Medical University from June,2016 to March 2020 were selected as the control group.The general data of patients,red blood cell count(RBC),HB,HCT,platelet(PLT)and three items of coagulation results were collected and analyzed retrospectively.The research content includes two parts: the first part,compare the general data of patients and blood indexes of early spontaneous abortion group and control group,Logistic regression and ROC curve were used to analyze the positive blood indexes,to clarify the relationship between them and early spontaneous abortion,and to explore its positive predictive value;The early spontaneous abortion group was further divided into subgroups to explore the effects of different times of spontaneous abortion,fetus protection drugs,different etiological subgroups of abortion(including endocrine factors and chromosome factors),before and after pregnancy on HB,HCT and three items of coagulation.The second part: take the control group as the research object,first,the control group was divided into subgroups to explore the effects of gestational age of abortion,maternal age on HB,HCT and three items of coagulation;thirdly,Speraman linear correlation was used to analyze age,HB,HCT,Prothrombin Times(PT),Fibrinogen(Fbg)and Partial thromboplastin time(APTT)to clarify the correlation between the above indexes,and explore their clinical significance.?Results?1.The levels of HCT,HB and Fbg in the early spontaneous abortion group were significantly higher than those data in the control group,and PT in early spontaneous abortion group was shorter than that in control group.There was no significant difference in RBC,PLT and APTT between the two groups.Logistic regression analysis showed that HCT,PT and Fbg were independent influencing factors of early spontaneous abortion.ROC curve showed that HCT and Fbg had predictive value for early spontaneous abortion,and the combination of them had higher predictive value.The best positive predictive values of HCT and Fbg were 39.15% and 3.21g/L respectively.2.In the early spontaneous abortion group: there was no significant difference in RBC,HB,HCT,PLT,PT,APTT and Fbg among the first abortion group,second abortion group,third or more abortion group(P> 0.05);There was no significant difference in RBC,HB,HCT,PLT,PT,APTT and Fbg between used fetus protection drugs group and not used fetus protection drugs group(P> 0.05);There was no significant difference in RBC,HB,HCT,PLT,PT,APTT and Fbg between endocrine abnormality group and chromosome abnormality group(P> 0.05);The levels of HB and HCT before pregnancy were higher than those in early pregnancy,and the difference was statistically significant(P< 0.05),There was no significant difference in RBC,PLT between before pregnancy and after pregnancy(P> 0.05).3.In the control group,There was no significant difference in RBC,HB,HCT,PLT,PT,APTT and Fbg between < 6 weeks gestation group and ? 6 weeks gestation group(P > 0.05).The levels of PT and APTT in the group of maternal age < 35 years old were lower than those in the group of maternal age ? 35 years old(P < 0.05).4.Take the control group as the object of study,Spearman correlation showed that there was negative correlation between age and PT,APTT,positive correlation between age and HCT,age and HB,HCT and HB,PT and APTT,and negative correlation between HCT,HB,Fbg and PT,(P < 0.05).?Conclusion?1.High HB and high HCT are related to early spontaneous abortion.Patients with early spontaneous abortion may have high viscosity state and pathological hypercoagulable state.2.HCT,PT and Fbg are independent influencing factors of early spontaneous abortion.HCT and Fbg have predictive value for early spontaneous abortion,and the combination of HCT and Fbg has higher predictive value.The corresponding best positive predictive values were 39.15% and 3.21 g / L,respectively.3.The gestational age of abortion,times of spontaneous abortion,different etiological of abortion and the fetus protection drugs had little effect on HB,HCT and three items of coagulation.Compared with the non-pregnant state,the maternal blood is diluted in the early pregnancy.4.There is a weak correlation between blood viscosity and blood coagulation,while older pregnant patients may have higher blood viscosity and blood coagulation,which should be paid more attention to.