正常妊娠与凝血指标：从孕早期到孕晚期

Normal pregnancy and coagulation profile: from the first through the third trimester.

作者信息

Ibeh Nancy, Okocha Chide Emmanuel, Aneke Chinawaeze John, Onah Christian Ejike, Nwosu Agatha Oluchi, Nkwazema Kenneth Amobi

出版信息

Niger J Med. 2015 Jan-Mar;24(1):54-7.

PMID:25807675

Abstract

BACKGROUND

Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery.

OBJECTIVE

To evaluate the influence of normal pregnancy on blood coagulation and to explore changes in activity from the first through the third trimester.

SUBJECT AND METHODS

Sixty (60) apparently healthy pregnant women (20 from each trimester) and 20 healthy non-pregnant age-matched controls were recruited. Each participant had Prothrombin time (PT). Activated partial thromboplastin time (APTT) and platelet count done. Multiple comparisons were made between control values and coagulation profile at different stages of pregnancy using the Bonferroni statistics. Results were expressed as means and standard deviations, p < 0.01 was significant at 95 % CI. Ethical approval for the study was obtained from the Institutional review board.

RESULTS

The means of the APTT were significantly lower in the first, second and third trimesters compared with controls (35.59 ± 4.95 seconds, 32.22 ± 5.79 seconds and 29.60 ± 3.66 seconds, respectively, vs. 40.55 ± 5.95 seconds; p = 0.01). Correspondingly, the platelet count was significantly lower in the 3 trimester of pregnancy compared with controls (178.35 ± 41.52 x 10(9)/L vs. 233.86 ± 55.34 x 10(9)/L; p < 0.01) and equally with level in the 2nd trimester (178.35 ± 41.52 x 10(9)/L vs. 232.10 ± 48.67 x 10(9)/L; p < 0.01).

CONCLUSION

The APTT and platelet counts are significantly lower in the 3 trimester of normal pregnancy.

摘要

背景

正常妊娠是一种高凝状态；是一种生理安全阀，旨在防止分娩时母体过度失血。

目的

评估正常妊娠对血液凝固的影响，并探讨妊娠早期至晚期凝血活性的变化。

对象与方法

招募了60名明显健康的孕妇（每个孕期20名）和20名年龄匹配的健康非孕妇作为对照。对每位参与者进行凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和血小板计数检测。使用Bonferroni统计方法对对照组值与妊娠不同阶段的凝血指标进行多次比较。结果以均值和标准差表示，在95%置信区间p<0.01具有显著性。该研究获得了机构审查委员会的伦理批准。

结果

与对照组相比，妊娠早期、中期和晚期的APTT均值显著降低（分别为35.59±4.95秒、32.22±5.79秒和29.60±3.66秒，而对照组为40.55±5.95秒；p = 0.01）。相应地，妊娠晚期的血小板计数与对照组相比显著降低（178.35±41.52×10⁹/L对233.86±55.34×10⁹/L；p<0.01），与妊娠中期水平相比同样降低（178.35±41.52×10⁹/L对232.10±48.67×10⁹/L；p<0.01）。