不同分娩方式下妊娠晚期及产褥期凝血五项变化及意义

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Abstract Objective To investigate the changes and significance of five items of coagulation in third trimester of pregnancy and puerperium under different delivery modes in order to the prevention and treatment of obstetric venous thromboembolism. Methods The clinical data of 1216 healthy single parturient women who delivered at term in Yangzhou Maternal and Child Health Hospital from January to May 2019 were retrospectively analyzed. According to the delivery mode, they were divided into delivery group (661 cases), cesarean section group (515 cases) and forceps group (40 cases). Five items of coagulation levels were compared during third trimester of pregnancy (within seven days before delivery) and puerperium (48 h after delivery). Results In the third trimester of pregnancy, there were no significant differences in five items of coagulation among three groups (P > 0.05). During puerperium, thrombin time (TT) in delivery group was shorter than that in the third trimester of pregnancy, fibrinogen (FIB) level was higher than that in the third trimester of pregnancy, D-dimer (DDI) level was lower than that in the third trimester of pregnancy, and the differences were statistically significant (P < 0.05); prothrombin time (PT) and activated partial prothrombin time (APTT) in cesarean section group were longer than those in the third trimester of pregnancy, TT was shorter than that in the third trimester of pregnancy, FIB level was higher than that in the third trimester of pregnancy, DDI level was lower than that in the third trimester of pregnancy, and the differences were statistically significant (P < 0.05); PT in the forceps group was longer than that in the third trimester of pregnancy, and FIB level was higher than that in the third trimester of pregnancy, and the differences were statistically significant (P < 0.05). PT and APTT in cesarean section group were longer than those in delivery group, FIB level was higher than that in delivery group, TT was shorter than that in delivery group; PT and APTT in forceps group were shorter than those in cesarean section group, while FIB level was lower than that in cesarean section group, and the differences were statistically significant (P < 0.05). Conclusion According to the five standards of coagulation for normal people, PT, APTT, and TT of the five items of coagulation in third trimester of pregnancy and puerperium pregnant women are all within the normal range, but FIB and DDI level are higher than the normal range, which is in line with the conclusion of blood hypercoagulability. Routine postpartum screening of DDI levels is not recommended as a basis for predicting venous thromboembolism disease in the puerperium. PT and APTT in puerperium of cesarean delivery pregnancy are longer than those in the third trimester of pregnancy, and the phenomenon of hypocoagulability appears.

Key words： Third trimester of pregnancy Puerperium Five items of coagulation Hypercoagulable state Deep venous thrombosis

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	ZHANG Jing ZHANG Lin REN Weijuan

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ZHANG Jing ZHANG Lin REN Weijuan. Changes and significance of five items of coagulation in third trimester of pregnancy and puerperium under different delivery modes#br#[J]. 中国医药导报, 2022, 19(6): 98-101.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I6/98

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