The Changes Of The Level Of Blood Routine And Sf And The Influence On Pregnancy Outcome For Women With Alpha Thalassemia

Objective:To study the changes of hemoglobin (Hb)、mean corpuscular volume(MCV)、mean corpuscular hemoglobin (MCH) and serum ferritin (SF) of women with different types alpha Thalassemia, and analyze the influence on pregnancy outcome, to provide the basis for prenatal care.Methods:35 early pregnant women with middle type of alpha thalassemia were selected in the hospital from July in 2013 to October in 2014 as the middle type group.Randomly selected 35 early pregnant women with light alpha thalassemia as the light type group,35 early pregnant women with silent alpha thalassemia as the silent type group and 35 early pregnant women with no thalassemia as the control group.To detect Hb, MCV, MCH and SF in pregnant 13 weeks ago(early pregnancy),14～27 weeks(mid pregnancy)and 28 weeks to childbirth(late pregnancy),and understand the above index changes and compare the pregnancy outcome.Result:(1)Hb of the middle type group in early pregnancy,mid pregnancy and late pregnancy were 103.00±14.45g/L,94.38±16.34g/L,80.38±18.54g/L, which was lower than the silent type group,the light type group and the control group.Hb of the light type group were lower than the silent type group and the control group at the same pregnancy period.The extent of the decline in Hb of the middle type group during the whole pregnancy were 11.21±2.03g/L, higher than the silent type group,the light type group and the control group.The extent of Hb of the light type group during the whole pregnancy was higher than the silent type group and the control group. (2)MCV of the middle type group in early pregnancy,mid pregnancy and late pregnancy were 70.13±3.92fl, 70.45±4.27fl,72.43±3.05fl, which was lower than the silent type group and the control group. At the same pregnancy period,MCV of the light type group were lower than the silent type group and the control group but higher than the middle type group.MCV of the light type group and the middle type group were increased,but MCV of the silent type group were decreased during the whole pregnancy.MCV of the control group were increased in mid pregnancy and decreased in late pregnancy. (3)MCH of the middle type group in early pregnancy,mid pregnancy and late pregnancy were 20.85±2.56pg, 20.03±2.67pg,19.91±1.88pg, which was lower than the silent type group, the light type group and the control group.MCH of the light type group were lower than the silent type group and the control group at the same pregnancy period. MCH of the middle type group,the light type group and the silent type group were decreased during the whole pregnancy.MCH of the control group were increased in mid pregnancy and decreased in late pregnancy. The level of MCH in late pregnancy was lower than early pregnancy. (4)SF of the middle type group in early pregnancy,mid pregnancy and late pregnancy were 120.01±42.33ng/ml,63.36±28.14ng/ml,41.38±20.94ng/ml.SF of the light type group and the middle type group were higher than the silent type group and the control group in early pregnancy. SF of four groups had no significant difference in mid and late pregnancy. The extent of the decline in SF during the whole pregnancy were the middle type group,the light type group, the silent type group and the control group respectively. (5)The reason of cesarean delivery among four groups:the incidence of fetal distress in the middle type group was the highest, there was no evident difference between the other three groups. (6)The newborn’s average weight of the middle type group was 2941.65±634.25g, which was lower than the silent type group,the light type group and the control group.The newborn’s average weight of the light type group was lower than the silent type group and the control group.Apgar score in one minute among four groups had no significant difference.Conclusion:(1)During the pregnancy,Hb of the women who with the light and middle type of alpha thalassemia were lower than that with silent type of alpha thalassemia and normal pregnant women and Hb of pregnant women were decreased.The more serious the thalassemia was, the higher the extent of the decline in Hb. (2)There were some rise in MCV of the women who with the light and middle type of alpha thalassemia during the pregnancy, but were some decline in MCH of them.Both of MCV and MCH who with the light and middle type of alpha thalassemia were below the normal value.Doctors should pay attention to them to avoid missed diagnosis. (3)SF of the women who with the light and middle type of alpha thalassemia were higher in early pregnancy.Along with the gestational age,the consumption of iron was increased in pregnant women,they would be lack of iron in late pregnancy and aggravate the degree of anemia. (4)There were no significant difference in Hb and SF between normal pregnant women and the the pregnant women who with the silent type of alpha thalassemia.Doctors should pay attention to identify them to avoid missed diagnosis. (5)Women who suffered from anemia during pregnancy would affect the pregnancy outcomes.Pregnant women should make physical examination in time and take measures to correct anemia so that they could reduce the incidence of adverse pregnancy outcomes.