Analysis of the changes of coagulation function and inflammation markers in intrahepatic cholestasis during pregnancy
10.3760/cma.j.cn101441-20190729-00327
- VernacularTitle:凝血功能与炎症标志物在妊娠期肝内胆汁淤积症中的变化分析
- Author:
Xiaotong SUN
1
;
Nan GUO
;
Tao QU
;
Chunming LI
;
Xiyan HE
;
Caifang YANG
;
Fan LU
;
Lili YANG
Author Information
1. 甘肃省人民医院，兰州 730000
- Publication Type:Journal Article
- Keywords:
Intrahepatic cholestasis of pregnancy;
Postpartum hemorrhage;
Pregnancy outcome;
Blood coagulation;
Neutrophil and lymphocyte ratio;
Platelet and lymphocyt
- From:
Chinese Journal of Reproduction and Contraception
2020;40(8):638-643
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.
