The Relationship Between Blood Viscosity Changes And Hypertensive Disorder Complicating Pregnancy

Objective:To study the changes of blood viscosity during late gestation in normal pregnant women and patients with hypertensive disorder complicating pregnancy, so as to explore the significance of them in monitoring, prevention and treatment of hypertensive disorder complicating pregnancy.Methods: A total of 87 patients with hypertensive disorder complicating pregnancy (29 cases of gestational hypertension,27 cases of mild preeclampsia patients and 31 cases of severe preeclampsia patients), 59 normal pregnant women and 42 normal non - pregnancy women were included. The changes of hemorheological parameters, platelet-related parameters, lipid parameters and albumin, which all reflect blood viscosity, were measured and analysized. The 31 patients with severe preeclampsia were divided into early onset and late onset, and their blood viscosity were compared.Results:①. Compare with the non-pregnant group,erythrocyte deformation indexes, ESR, ESR K values,Fg in the normal term pregnancy group were significantly increased, while the whole blood viscosity of low earnest, hematocrit, erythrocyte aggregation index were significantly decreased(P<0.05).②. Compared with the normal term pregnancy group, the parameters of plasma viscosity in patiens with hypertensive disorder complicating pregnancy were all significantly increased. HCT, low shear viscosity of whole blood,erythrocyte aggregation indexes and K values of ESR in the the severe preeclampsia group were significantly higher than the other groups ( P < 0. 05). As the pathogenetic conditions of patients with preeclampsia progressed, these changes became more evident.③.Compared with the normal pregnant group, MPV,PDW of the gestational hypertension group showed an increasing tendency,and PLT was significantly increased ( P < 0. 05) ;As the pathogenetic conditions of patients with preeclampsia progressed, PLT was significantly decreased, while PCT and PDW were significantly increased (P <0.05). ④.Compared with the normal late pregnancy, CHOL, TG and LDL/HDL of the hypertensive disorder complicating pregnancy group were significantly higher, while HDL was significantly lower (P <0.05). As the pathogenetic conditions of patients with preeclampsia progressed, lipid levels were significantly changed (P <0.05).⑤. With the progression of hypertensive disorder in pregnancy, ALB and ALB / GLB were significantly reduced (P <0.05).⑥. In patients with pregnancy induced hypertension, with the elevation of blood viscosity and the progression of pathogenetic conditions,maternal complications,the incidence rates of cesarean section, premature children, FGR, neonatal asphyxia and stillbirth were significantly higher (P <0.05).⑦. In the patients with severe preeclampsia, parameters of blood rheology, platelet-related parameters, and lipid levels were significantly higher in the early-onset group than in the late-onset group, and the incidence of neonatal complications was higher.⑧Blood viscosity was positively correlated with lipid;low shear viscosity and LDL/HDL were negatively correlated with birth weight. Conclusions: In patients with hypertensive disorder complicating pregnancy, there are abnormal blood rheology, platelet numbers and function,as well as abnormal lipid and protein metabolism, which influence the changes in blood viscosity, leading to increased cesarean section rate and perinatal adverse outcome.