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目的分析妊娠合并血小板减少症对产妇、新生儿及分娩方式的影响。方法对2004年1月至2008年12月收治的65例妊娠合并血小板减少症患者,就分娩及麻醉方式、产后出血情况、新生儿情况及产后血小板恢复情况等进行回顾分析。结果65例中经阴道自然分娩32例,会阴侧切分娩15例,剖宫产18例。剖宫产18例中伴有产科指征12例。经阴道自然分娩及行会阴侧切分娩者,产时产后出血量近似于正常分娩,剖宫产术中平均出血量230ml,无产后出血。无新生儿颅内出血及其他出血症状。除5例确诊的特发性血小板减少性紫癜(idiopathic throm bocytopenic purpura,ITP)合并妊娠的产妇以外,60例产妇产后血小板均在1周内恢复正常,不再下降。结论妊娠合并血小板减少症只要处理得当,对孕母及胎儿均不增加其出血风险,分娩方式的选择主要根据产科指征。
Objective To analyze the influence of pregnancy complicated with thrombocytopenia on maternal, newborn and mode of delivery. Methods From January 2004 to December 2008, 65 cases of pregnancy with thrombocytopenia were retrospectively analyzed in terms of labor and anesthesia, postpartum hemorrhage, newborns and postpartum platelet recovery. Results 65 cases of vaginal natural delivery in 32 cases, 15 cases of episiotomy lateral delivery, 18 cases of cesarean section. Cesarean section in 18 cases with obstetric indications in 12 cases. Transvaginal natural childbirth and perineal incision delivery, labor-time postpartum bleeding is similar to normal delivery, the average amount of bleeding in cesarean section 230ml, no postpartum hemorrhage. No neonatal intracranial hemorrhage and other bleeding symptoms. In addition to 5 confirmed idiopathic thrombocytopenic purpura (idiopathic thromocytopenic purpura, ITP) combined with pregnant mothers, 60 maternal postpartum platelets returned to normal within 1 week, no further decline. Conclusion Pregnancy with thrombocytopenia as long as properly handled, pregnant women and fetuses do not increase the risk of bleeding, choice of mode of delivery based mainly on obstetric indications.