妊娠合并重度血小板减少症对分娩时机及分娩方式的影响

目的：探讨妊娠合并重度血小板减少症对产妇分娩时机、分娩方式及母婴安全的影响。方法对32例妊娠合并重度血小板减少症患者（观察组）及38例妊娠合并轻中度血小板减少症患者（对照组）的临床资料进行回顾性分析，对2组患者的分娩时机、分娩方式及产后出血、新生儿颅内出血等情况进行比较。结果观察组平均妊娠（33．8±1．3）周，对照组平均妊娠（37．8±2．7）周，2组比较差异有统计学意义（P ＜0．05）。观察组的早产率及产后出血率分别为28．1％和9．4％，对照组早产率和产后出血率分别为2．6％和2．6％，2组比较差异均有统计学意义（均 P ＜0．05）。2组剖宫产率比较差异无统计学意义（P ＞0．05）。2组均未发现新生儿颅内出血病例。结论妊娠合并重度血小板减少症患者需要妇产科与血液病科医生共同管理，重视其早产率及产后出血率升高的事实，充分评估内科及产科并发症，在一定程度上仍可获得满意的自然分娩率。

Effects of Severe Thrombocytopenia in Pregnancy on Timing and Mode of Delivery

Objective To investigate the effects of severe thrombocytopenia in pregnancy on delivery timing,delivery mode and maternal-infant safety.Methods Clinical data of 32 patients with severe thrombocytopenia in pregnancy （observation group）and 38 patients with mild and medium thrombocytopenia in pregnancy （control group）were retrospectively analyzed.Delivery timing,delivery mode,postpartum hemorrhage and neonatal intracranial hemorrhage were com-pared between the two groups.Results Average pregnancy duration,preterm birth rate and post-partum hemorrhage rate were,respectively,（33.8±1.3）weeks,28.1% and 9.4% in observation group,and （37.8±2.7）weeks,2.6% and 2.6% in control group.There were significant differ-ences between the two groups （all P 〈0.05）.No significant difference in cesarean section rate was found between the two groups （P 〈0.05）.No neonatal intracranial hemorrhage occurred in both groups.Conclusion Patients with severe thrombocytopenia in pregnancy should be co-man-aged by obstetricians and hematological doctors.The satisfactory spontaneous labor rate can be obtained through paying attention to the increased incidences of preterm birth and postpartum hemorrhage and evaluating medical and obstetric complications.