Department of Gynecology and Obstetrics, Fujian Provincial Maternity and Children Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China.
J Coll Physicians Surg Pak. 2020 Mar;30(3):276-281. doi: 10.29271/jcpsp.2020.03.276.
To determine the regular changes of blood coagulation indices in twin pregnancy complicated with preeclampsia (PE).
Descriptive study.
Fujian Provincial Maternity and Children Hospital from January 2014 to December 2017.
A total of 180 twin pregnancies were enrolled in this study, including 40 diagnosed as PE, 50 as severe PE (SPE), and 90 as normal twin pregnancies. The changes of coagulation parameters of twin pregnant women in different gestational states and periods were retrospectively analysed.
During the middle and late pregnancies in all groups, the PT (prothrombin time) decreased, and D-Di (D-dimers) increased gradually compared to early pregnancy (p <0.05). When D-Di increased abnormally, adverse pregnancy outcomes increased. APTT (activated partial thromboplastin time) and TT (thromoplastin time) were shortened first and then significantly prolonged (p <0.05). In the normal twin group, FIB was increased gradually from early pregnancy to midlate pregnancy; in the PE group, FIB was increased and then decreased, especially in the sPE group (p <0.05). There was no significant difference in coagulation function in early pregnancy (p >0.05). FIB in sPE group was lower than that in other two groups in late pregnancy. TT in sPE group was higher than that in other two groups. D-Di and APTT in PE group and sPE group were higher than those in normal group (p <0.05). The TT sensitivity was 68.8% with specificity 72.4%, at cut-off value of 13.48 s (p <0.01).
The regular changes of blood coagulation indices in twin pregnancy complicated with PE had great predictive and diagnostic value of preeclampsia.
探讨双胎妊娠并发子痫前期(PE)患者凝血功能指标的变化规律。
描述性研究。
福建省妇幼保健院,2014 年 1 月至 2017 年 12 月。
本研究共纳入 180 例双胎妊娠患者,其中 40 例诊断为 PE,50 例为重度 PE(sPE),90 例为正常双胎妊娠。回顾性分析不同妊娠状态和时期双胎妊娠孕妇凝血参数的变化。
各组中孕期和晚孕期 PT(凝血酶原时间)较早孕期逐渐下降,D-Di(D-二聚体)逐渐升高(p<0.05)。当 D-Di 异常升高时,不良妊娠结局增加。APTT(活化部分凝血活酶时间)和 TT(凝血酶时间)先缩短后显著延长(p<0.05)。在正常双胎组中,FIB(纤维蛋白原)从早孕期逐渐增加到中孕期和晚孕期;在 PE 组中,FIB 先升高后降低,尤其是 sPE 组(p<0.05)。早孕期凝血功能无显著差异(p>0.05)。sPE 组晚孕期 FIB 低于其他两组。sPE 组 TT 高于其他两组。PE 组和 sPE 组的 D-Di 和 APTT 高于正常组(p<0.05)。TT 的灵敏度为 68.8%,特异度为 72.4%,截断值为 13.48 s(p<0.01)。
双胎妊娠并发 PE 患者凝血功能指标的变化规律对预测和诊断子痫前期具有重要价值。