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妊娠合并凝血因子Ⅺ缺乏症临床分析

Clinical analysis of pregnancy complicated with factor Ⅺ deficiency

  • 摘要:
    目的 探讨妊娠合并凝血因子Ⅺ缺乏症的诊治策略及母儿结局。
    方法 选取2015年1月至2020年4月上海交通大学医学院附属瑞金医院产科收治的妊娠合并凝血因子Ⅺ缺乏症患者11例,回顾性分析其诊疗策略及母儿转归。
    结果 11例患者中9例足月妊娠,另2例由于个人因素要求行人工流产术,均于术前输注新鲜冰冻血浆纠正凝血功能后行剖宫产术或负压吸宫术终止妊娠。9例足月妊娠均行剖宫产术,产后出血量(500.00±291.55)mL,其中1例发生产后大出血(出血量1 200 mL)。行人工流产术患者2例,均行负压吸宫术,术中出血约10 mL。9例均为足月活产儿,其中1例新生儿为足月低体质量儿,出生体质量为1 980 g。所有新生儿Apgar初评均为10分,无畸形,出生后凝血功能均正常。
    结论 妊娠合并凝血因子Ⅺ缺乏症通常无出血倾向,但仍需警惕产后出血,术前予输新鲜冰冻血浆纠正凝血功能后行剖宫产术或计划生育手术可减少术后出血的发生。该病患者所产新生儿未见凝血功能异常。

     

    Abstract:
    Objective To explore the diagnosis and treatment strategy and maternal and fetal outcome of pregnancy with coagulation factor Ⅺ deficiency.
    Methods From January 2015 to April 2020, 11 pregnant women with coagulation factor Ⅺ deficiency were selected. Their clinical manifestations, treatment strategies, and maternal and fetal outcomes were retrospectively analyzed.
    Results Among the 11 cases of pregnancy with coagulation factor Ⅺ deficiency, 9 cases had a full-term pregnancy, and 2 cases underwent dilatation curettage due to personal factors. Before the operation, fresh frozen plasma was injected to correct the coagulation function, and then cesarean section or dilatation curettage was performed to terminate the pregnancy. Cesarean section was performed in 9 full-term pregnancies, with a postpartum bleeding volume of (500.00 ±291.55) mL, and one case had a postpartum hemorrhage of 1 200 mL. In 2 cases of induced abortion, intraoperative bleeding was about 10 mL. Nine cases were full-term live births, among which one newborn was full-term low birth weight with a birth weight of 1 980 g. All the neonates had no deformity. The Apgar scores of neonates were all 10, and the blood coagulation function was normal.
    Conclusions Patients with factor Ⅺ deficiency in pregnancy usually have no bleeding tendency, but their postpartum hemorrhage still needs attention. Preoperative fresh frozen plasma transfusion to correct coagulation function and cesarean section or induced abortion can reduce the occurrence of postoperative bleeding. No abnormal coagulation function was observed in neonates born to the patients with the disease.

     

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