Predictive Value Of Coagulation And Fibrinolysis Index In Third Trimester For Postpartum Hemorrhagein Low Risk Pregnant Women

Objective To explore the predictive value of coagulation and fibrinolysis index in third trimester for postpartum hemorrhage in low risk pregnant women.Methods A retrospective cohort of pregnant women who suffered Postpartum hemorrhage after delivery(225 cases)at International Peace Maternity and Child Health Hospital,Shanghai China from January 1,2014 to the December 30,2015 was conducted.Healthy pregnant women who were hospitalized at the same time(1000 cases).All of them were full-term without complications.The definition of postpartum hemorrhage for hemorrhage more than 500 ml in 24 h after fetal childbirth.Peripheral blood was collected to measure D-dimer during 32~34 gestational weeks,and to measure Platelet count(PLT),plasma fibrinogen(FIB),prothrombin time(PT),partially activated thromboplastin time(APTT),thrombin time(TT)during 37-42 gestational weeks.To explore the predictive value of coagulation and fibrinolysis index in third trimester for postpartum hemorrhage in low risk pregnant women.Results 1.The higher the plasma D-D content in the third trimester(P = 0.000,OR = 3.347,95% CI: 2.593-4.319),the risk of postpartum hemorrhage increased;2.The lower the PLT level(P = 0.015,OR = 1.184,95% CI: 1.033-1.358)increased the risk of postpartum hemorrhage;3.The higher the PLT level(P = 0.033,OR = 0.997,95% CI: 0.993-1.000)increased the risk of postpartum hemorrhag;4.Determination of maternal pregnancy and D-D content has great value in predicting the incidence of postpartum hemorrhage,when the content of D-D was 1.425g/L,the Youden index was maximum,the sensitivity was 43.9%,the specificity was 87.1%,and the area under the ROC curve was 0.701(P < 0.001).Conclusion The level of D-D,PT and PLT were correlated with the incidence of postpartum hemorrhage in the pregnant women.When the plasma D-D level increased,PT level increased,PLT level decreased,increased probability postpartum hemorrhage.The detection of D-D concentration in third trimester can be used as one of the methods to predict postpartum hemorrhage.Timely monitoring of D-D and other indicators of coagulation and fibrinolysis during pregnancy can help to determine the status of coagulation function in pregnant women.It is of great significance for clinical prevention and treatment of postpartum hemorrhage,and to reduce the occurrence of postpartum hemorrhage.