Study On The Correlation Between Anemia Of Twin Pregnancy And Cardiac Function Factors

ObjectivesBy studying the changes of hemoglobin,albumin,BNP,myocardial enzymes,cardiac ultrasound and electrocardiogram of pregnant women with anemia during twin pregnancy,observe the physiological and adaptive changes of cardiac function caused by normal twin pregnancy,and establish twins Pregnancy cardiac ultrasound mode.At the same time,in-depth understanding of the effects of twins with anemia on the functional status and structure of pregnant women's heart,screening of key observation indicators for early heart failure caused by anemia,guiding clinical to take effective preventive and treatment measures as soon as possible,thereby improving the maternal and perinatal outcome of childbirth is of great significance for reducing maternal mortality and perinatal mortality.MdehodsThis study collected a total of 473 twin pregnant women who were admitted to the Northwest Women's and Children's Hospital from January 2017 to November 2019 and met the inclusion criteria.A retrospective survey of 473 cases of twin pregnancy pregnant women's electronic medical records: age,education level,BMI before pregnancy,pregnancy,medication history during pregnancy,current conception,chorionic sex,gestation week,complications during pregnancy,liver and kidney Work,hemoglobin,BNP,myocardial enzymes,cardiac B-ultrasound,electrocardiogram,neonatal complications,and number of days in the NICU.The hemoglobin of the study subjects after admission was divided into the uniform anemia standard for pregnancy during the World Health Organization(mild anemia 100 g / L?hemoglobin <110g / L,moderate anemia 70 g / L?hemoglobin<100g / L,severe anemia 40 g / L?hemoglobin<70g / L): Non-anemic pregnant women group(262 cases),anemia pregnant women group(211 cases,including mild anemia and moderate anemia).In addition,211 cases of anemia pregnant women were divided into 2 groups according to Chinese guidelines for diagnosis and treatment of heart failure: anemia combined with heart failure group and anemia non-heart failure group.SPSS 22.0 was used to statistically analyze the basic information of pregnant women in each group,complication during pregnancy,cardiac indicators,and birth status of the newborn.Results1.The natural pregnancy and assisted reproduction,the gestational age of childbirth were ? 34 weeks and> 34 weeks in the anemia pregnant women group and the non-anaemia pregnant women group,which had significant statistical significance.2.The incidence of heart failure in the group of anemia pregnant women was 10.90%,which was statistically significant compared with 0 in the group of non-anemic pregnant women.There were no statistically significant differences between the two groups in other complications of preeclampsia,severity of intrahepatic cholestasis during pregnancy,gestational diabetes,and hypothyroidism during pregnancy.3.Compared with moderate anemia group,the incidence of albumin content,whole blood BNP content,and a small amount of mitral regurgitation were significantly different between the non-anemic group and the moderate anemia group;the creatine kinase was compared between the non-anemic group,the mild anemia group,and the moderate anemia group.The isoenzyme content and cardiac B-ultrasound E value were statistically significant;the incidence of a small amount of mitral regurgitation in the mild anemia group was lower than that in the moderate anemia group,and the difference was statistically significant.Non-anemic pregnant women combined with pregnancy complications,mild anemia pregnant women combined with pregnancy complications and moderate anemia pregnant women combined with pregnancy complications compared creatine kinase isoenzyme,cardiac ultrasound mitral valve regurgitation and ECG arrhythmia,There is significant statistical significance.4.The birth weight,length,intraventricular hemorrhage,heart disease,and number of days of staying in the NICU of the first neonate and the number of days of staying in the NICU of the second neonate were significantly statistically significant in the anemia pregnant women group and the non-anaemia pregnant women group.5.Compared with the group of anemia pregnant women with heart failure and the group of anemia non-heart failure pregnant women,the pre-pregnancy BMI <24,24?BMI <28and BMI?28 have significant statistical significance.6.Compared with pregnant women with anemia combined with heart failure and those with anemia non-heart failure,BNP,creatine kinase,a-hydroxybutyric acid,left ventricular end-systolic diameter,and tricuspid regurgitation were small,which had statistical significance.7.Comparison of the first neonatal length,second neonatal length,first neonatal necrotizing enterocolitis,second neonatal respiratory distress syndrome,and first newborn the number of children staying in the NICU and the number of days of the second neonatal staying in the NICU were statistically significant.Conclusions1.In twin pregnancy,the incidence of anemia in naturally conceived patients will increase.Cardiac function,especially cardiac ultrasound,will produce physiological and adaptive index changes with the increase of the gestational weeks of twin pregnancy,that is,the normal cardiac ultrasound mode of twin pregnancy.However,when anemia iscombined,some leading indicators of cardiac function change,such as decreased albumin,in cardiac ultrasound E and a small increase in cardiac mitral regurgitation;Especially when early heart failure occurs in twins with anemia during pregnancy,cardiac function is abnormally changed,but the leading indicators of clinical significance are whole blood BNP content,creatine kinase content,a-hydroxybutyric acid content increase,left ventricle at the end of systole,the diameter increased and the tricuspid regurgitation increased slightly.Therefore,in the early stage of heart failure with twin pregnancy anemia,in addition to obesity is a high risk factor,the above leading indicators can be used as high risk factors for heart failure.Its significance lies in guiding the clinical early diagnosis and early treatment of early heart failure to avoid further development of heart failure and cause adverse outcomes for patients.2.Maternal anemia and inadequate nutrition,including vitamin and trace element deficiencies,may cause fetal uterine dysplasia and even fetal developmental abnormalities.Especially in neonates with anemia and heart failure,in addition to weight and height,necrotizing enterocolitis,neonatal respiratory distress syndrome,and neonatal acute severe illness occur.At the same time,the number of newborns staying in the NICU increased and the financial burden increased.Therefore,patients with twin pregnancy anemia should be detected,corrected,and treated early to avoid intrauterine dysplasia and malformations.At the same time,reduce the occurrence of early heart failure in the mother,so as not to cause acute neonatal severe illness and cause adverse outcomes for the mother and child.In short,anemia during twin pregnancy impairs pregnant women's left ventricular systolic function,increasing the incidence of heart failure during pregnancy,and the birth conditions and pregnancy outcomes of newborns are also poor;the pre-pregnancy body mass index of twin pregnant women is anemia during pregnancy Pregnant women are at high risk for heart failure,pay attention to the changes in the leading indicators of heart function,and make early diagnosis and treatment of early heart failure to avoid further development of heart failure,causing adverse outcomes for patients and newborns.Health education before and during pregnancy should be strengthened,pregnant women's awareness of anemia during pregnancy should be enhanced,the importance of weight management before pregnancy should be emphasized,and early prevention and treatment of anemia should be carried out to ensure the safety of mothers and infants.