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目的探讨妊娠期血小板减少的原因及对围产结局的影响。方法回顾性分析安徽省立医院2008—2014年间足月分娩的85例妊娠合并血小板减少患者的临床资料,并选取同一时期血小板计数正常的85例妊娠妇女作为对照。结果妊娠合并血小板减少的患者中妊娠期血小板减少症(GT)69例(占81.2%),其中自然分娩58例,剖宫产11例;特发性血小板减少性紫癜(ITP)10例(占11.7%),其中自然分娩3例,剖宫产7例;其他原因引起的血小板减少6例(占7.1%),其中自然分娩2例,剖宫产4例。产后出血GT组4例(5.7%),ITP组4例(40.0%),其他病因组2例(33.3%)。对照组自然分娩70例,剖宫产15例,产后出血1例(1.2%)。结论妊娠合并血小板减少患者的分娩方式取决于血小板水平、原发病的情况及产科因素。严重血小板减少患者剖宫产率及产后出血率增加。
Objective To investigate the causes of thrombocytopenia during pregnancy and its effect on perinatal outcome. Methods The clinical data of 85 pregnant women with term thrombocytopenia who underwent full-term delivery during 2008-2014 in Anhui Provincial Hospital were analyzed retrospectively. Totally 85 pregnant women with normal platelet count in the same period were selected as controls. Results Among the patients with gestational thrombocytopenia, 69 cases (81.2%) had gestational thrombocytopenia (GT), including 58 cases of spontaneous labor and 11 cases of cesarean section; 10 cases of idiopathic thrombocytopenic purpura (ITP) 11.7%), including 3 cases of natural childbirth and 7 cases of cesarean section; 6 cases of other causes of thrombocytopenia (7.1%), including 2 cases of spontaneous delivery and 4 cases of cesarean section. Postpartum hemorrhage was found in 4 patients (5.7%) in GT group, 4 patients (40.0%) in ITP group and 2 patients (33.3%) in other etiology group. Control group, 70 cases of natural childbirth, 15 cases of cesarean section, postpartum hemorrhage in 1 case (1.2%). Conclusion The mode of delivery in pregnant women with thrombocytopenia depends on the level of platelets, the primary disease and obstetric factors. Cesarean section rate and postpartum hemorrhage rate in patients with severe thrombocytopenia increased.