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目的 探讨妊娠合并血小板减少的病因及围生期处理方法。方法 总结 1994～ 2 0 0 3年间 98例妊娠合并血小板减少患者的临床资料。结果 妊娠合并血小板减少的主要原因包括妊娠相关性血小板减少症(PAT) ,特发性血小板减少性紫癜 (ITP)和妊娠期高血压疾病 (妊高征 )。治疗方法为在治疗原发病的基础上 ,对血小板计数 <5 0× 10 9/L者于分娩前后短期使用糖皮质激素及血小板制剂。 98例中阴道分娩 34例 ,剖宫产 6 4例 ;发生产后出血 12例 ,产后出血发生率为 12 2 % ;胎死宫内 3例。新生儿血小板减少 7例。结论 在针对病因治疗的基础上 ,糖皮质激素及血小板制剂是治疗严重妊娠合并血小板减少的有效手段。
Objective To investigate the etiology and perinatal treatment of pregnancy with thrombocytopenia. Methods The clinical data of 98 cases of pregnancy with thrombocytopenia between 1994 and 2003 were summarized. Results The main causes of pregnancy associated with thrombocytopenia include pregnancy associated thrombocytopenia (PAT), idiopathic thrombocytopenic purpura (ITP) and gestational hypertension (PIH). Treatment is based on the treatment of primary disease, the platelet count <5 0 × 10 9 / L shortly before and after delivery glucocorticoid and platelet preparations. Among 98 cases, 34 were vaginal delivery and 64 were cesarean; 12 were postpartum hemorrhage, 12 2% were postpartum hemorrhage, and 3 were intrauterine fetal death. Neonatal thrombocytopenia in 7 cases. Conclusion Based on the treatment of etiology, glucocorticoids and platelet preparations are effective in treating severe pregnancy with thrombocytopenia.