血液病合并妊娠临床上以贫血为多见,多为缺铁性贫血;而巨幼红细胞性贫血、再生障碍性贫血和溶血性贫血等较少见。另如血小板减少性紫癜、白血病等出血性疾病则更为少见。这些血液病常并有贫血及/或血小板减少,是分娩时导致宫缩乏力及凝血功能障碍引起产后出血的主要原因。 1 血液病合并妊娠产后出血的主要原因 1.1 贫血导致宫缩乏力血液病病人常并有贫血。我院23年来收治孕产妇30 605例中,贫血1 199例,发生率为3.92%,其中重度贫血53例,占0.17%。原发性血小板减少性紫癜病人中约20%合并贫血。我院20年妊娠合并白血病发病率占孕产妇的25/10万,其中75%合并贫血。当血红蛋白低于80g/L,尤其是重度贫血血红蛋白<60g/L时,常使子宫肌纤维缺血、缺氧,导致宫缩乏力,发生产后出血。我院与北医大三院23年重度贫血发生产后出 Anemia is more common in blood disease complicated with pregnancy, mostly iron deficiency anemia; megaloblastic anemia, aplastic anemia and hemolytic anemia are rare. The other such as thrombocytopenic purpura, leukemia and other bleeding disorders are even more rare. These blood diseases often have anemia and / or thrombocytopenia and are the main causes of postpartum hemorrhage resulting from uterine inertia and coagulation dysfunction during childbirth. A hematological disease complicated with postpartum bleeding in pregnancy the main reason 1.1 anemia lead to uterine inertia patients with blood diseases often have anemia. In our hospital for 23 years, 30 605 pregnant women were enrolled, of which 1,199 were anemic patients, the incidence rate was 3.92%, of which 53 cases were severe anemia, accounting for 0.17%. About 20% of patients with primary thrombocytopenic purpura have anemia. My hospital 20-year pregnancy incidence of leukemia accounted for 25/10 million pregnant women, of which 75% with anemia. When hemoglobin is less than 80g / L, especially severe anemia hemoglobin <60g / L, often make the uterine muscle fiber ischemia and hypoxia, leading to uterine inertia, postpartum hemorrhage occurred. Our hospital and North Third Congress Habitat 23 cases of severe anemia postpartum