Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan; Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.
Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Taiwan J Obstet Gynecol. 2024 May;63(3):381-386. doi: 10.1016/j.tjog.2023.12.001.
Longitudinal hematological changes throughout twin pregnancies have not been reported. This study aimed to reveal longitudinal changes in hematological indices in twin pregnancies.
We conducted a retrospective chart review of hematological changes in uncomplicated twin pregnancies delivered at ≥37 weeks of gestation between 2010 and 2013 and randomly selected uncomplicated singletons during the same period. A complete blood count and hemogram were performed as blood examinations in the first trimester (9-13 weeks), late second trimester (22-27 weeks), mid-third trimester (33-35 weeks, only in twin pregnancies), and late third trimester (36-38 weeks). We evaluated inter-trimester differences in hematological indices and compared the values between twin and singleton pregnancies in each trimester.
The final analysis group included 60 twin pregnancies and 63 singleton pregnancies. The white blood cell (WBC) count in twin pregnancies decreased throughout the pregnancy after the first trimester and became significantly lower than that in singletons in the late third trimester. The WBC count showed only a slight decrease in the third trimester in singleton pregnancies, whereas it showed a marked decrease throughout the pregnancy in twin pregnancies. The marked decrease in the total WBC count in twin pregnancies is mainly due to a decrease in neutrophils. The red blood cell count and hemoglobin and hematocrit values in twin pregnancies showed more marked decreases in the second trimester than in singletons. No decrease was observed after the second trimester of pregnancy. The platelet count decreased in the third trimester of twin pregnancies.
We clarified the longitudinal hematological changes in twin pregnancies that showed augmentation of or differed from those of singleton pregnancies. It should be specifically mentioned that the WBC count markedly decreased through pregnancy after the first trimester, which is a characteristic change in twin pregnancies.
尚未有关于双胎妊娠期间血液学变化的纵向研究报道。本研究旨在揭示双胎妊娠期间血液学指标的纵向变化。
我们对 2010 年至 2013 年间在妊娠 37 周以上分娩的无并发症双胎妊娠和同期随机选择的无并发症单胎妊娠进行了回顾性图表分析。在妊娠早期（9-13 周）、妊娠中期晚期（22-27 周）、妊娠晚期中期（33-35 周，仅适用于双胎妊娠）和妊娠晚期晚期（36-38 周）进行全血细胞计数和血液检查。我们评估了各孕期血液学指标的差异，并比较了各孕期双胎和单胎妊娠的数值。
最终的分析组包括 60 例双胎妊娠和 63 例单胎妊娠。双胎妊娠的白细胞（WBC）计数在妊娠早期后整个孕期逐渐下降，在妊娠晚期明显低于单胎妊娠。单胎妊娠的 WBC 计数仅在妊娠晚期略有下降，而双胎妊娠的 WBC 计数则整个孕期明显下降。双胎妊娠总 WBC 计数的明显下降主要是由于中性粒细胞减少。双胎妊娠的红细胞计数、血红蛋白和血细胞比容值在妊娠中期比单胎妊娠下降更为明显。妊娠中期后没有下降。双胎妊娠的血小板计数在妊娠晚期下降。
我们阐明了双胎妊娠的纵向血液学变化，这些变化与单胎妊娠的变化既有相似之处，也有不同之处。需要特别指出的是，WBC 计数在妊娠早期后整个孕期明显下降，这是双胎妊娠的一个特征性变化。
