Department of Gynecology & Obstetrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Int J Gynaecol Obstet. 2021 Apr;153(1):89-94. doi: 10.1002/ijgo.13554. Epub 2021 Feb 11.
To investigate the effect of mild thrombocytopenia (platelet count: 100 000-149 000/µl) on peripartum hemorrhage in elective cesarean deliveries.
This study was conducted between January 2018 and May 2019 in a hospital, located in Konya, Turkey. Uncomplicated pregnancies undergoing elective cesarean section were included. Of 1992 eligible patients, 201 women were determined as the mild thrombocytopenia group, 48 women as the severe thrombocytopenia group, and 1743 women as the control group. The estimated blood loss volume (EBLV), the need for blood transfusion, and excessive blood loss rates were compared among groups. Logistic regression analysis was performed for potential confounding factors.
The EBLV and excessive blood loss ratios were significantly higher in the mild thrombocytopenia group compared with the control group (P < 0.001 and P < 0.05, respectively). There was no significant difference between the mild thrombocytopenia and control groups in terms of the number of patients receiving a blood transfusion. The probability of excessive blood loss was significantly higher in the mild thrombocytopenia group, even after adjusting the odds ratio for confounding factors (adjusted odds ratio 1.94, 95% confidence interval 1.27-2.95, P = 0.002).
Mild thrombocytopenia appears to increase the likelihood of peripartum hemorrhage in elective cesarean deliveries in uncomplicated pregnancies.
探讨轻度血小板减少症（血小板计数：100000-149000/µl）对择期剖宫产围产期出血的影响。
本研究于 2018 年 1 月至 2019 年 5 月在土耳其科尼亚的一家医院进行。纳入无并发症的择期剖宫产孕妇。在 1992 名符合条件的患者中，201 名患者被确定为轻度血小板减少症组，48 名患者为严重血小板减少症组，1743 名患者为对照组。比较各组的估计失血量（EBLV）、输血需求和过度失血率。对潜在混杂因素进行逻辑回归分析。
与对照组相比，轻度血小板减少症组的 EBLV 和过度失血率显著升高（P<0.001 和 P<0.05）。轻度血小板减少症组和对照组之间输血患者的数量没有显著差异。即使调整了混杂因素的比值比（调整后的比值比 1.94，95%置信区间 1.27-2.95，P=0.002），轻度血小板减少症组发生过度失血的概率仍显著升高。
在无并发症的择期剖宫产中，轻度血小板减少症似乎增加了围产期出血的可能性。
