三胎妊娠产妇血小板减少症的发生率及病因。

First Department of Obstetrics and Gynecology, Semmelweis University Faculty of Medicine, Budapest, Hungary.

J Perinat Med. 2012 Jan 6;40(3):229-35. doi: 10.1515/jpm.2011.123.

OBJECTIVE

To determine the incidence, clinical significance and causes of maternal thrombocytopenia in triplet gestations.

STUDY DESIGN

The study population consisted of 150 patients with triplet gestation that delivered at our department between 1990 and 2008. Thrombocytopenia was defined as a platelet count <150,000/μL. Patients were classified on the basis of the lowest recorded platelet count observed during pregnancy.

RESULTS

A low platelet count was observed during the triplet gestation in 36 cases (24.0%), and after delivery in another 19 cases (12.7%). Thrombocytopenia was mild, moderate, and severe in 75% (27/36), 16.7% (6/36), and 8.3% (3/36) of the cases, respectively. During pregnancy, thrombocytopenia was associated with pregnancy-induced hypertension in 25.0% (9/36) of patients, while gestational thrombocytopenia was diagnosed in 72.2% of the cases (26/36). The mean platelet count showed a strong negative correlation with gestational age (r=-0.953, P<0.001), and at 36 weeks approached the limit of thrombocytopenia.

CONCLUSIONS

Thrombocytopenia occurs more frequently in triplet gestations than in the general pregnant population, and the rate of moderate and severe forms is higher. The distribution of causes is comparable to that of the general pregnant population. The average platelet count in triplet gestations decreases with gestational age.

目的

确定三胎妊娠中产妇血小板减少症的发生率、临床意义和原因。

研究设计

研究人群包括 1990 年至 2008 年在我院分娩的 150 例三胎妊娠患者。血小板减少症定义为血小板计数<150,000/μL。根据妊娠期间观察到的最低血小板计数对患者进行分类。

结果

36 例（24.0%）在三胎妊娠期间和 19 例（12.7%）在分娩后出现血小板计数低。血小板减少症在 75%（27/36）、16.7%（6/36）和 8.3%（3/36）的病例中分别为轻度、中度和重度。妊娠期间，血小板减少症与妊娠高血压相关的占 25.0%（9/36），而妊娠期血小板减少症在 72.2%的病例中被诊断（26/36）。血小板计数平均值与孕龄呈强负相关（r=-0.953，P<0.001），36 周时接近血小板减少症的极限。