Clinical Research On Changes Of Platelet And Coagulation Parameters In The Third Trimester Of Pregnancy In HELLP Syndrome

ObjectiveTo investigate the changes of platelet and coagulation parameters in HELLP syndrome in the third trimester of pregnancy.MethodsThis is a retrospective analysis of clinical data of 450 pregnant women,including 150cases of HELLP Syndrome,150 cases of preeclampsia,and 150 cases of healthy full-term pregnant women,who delivered in Fujian Maternal and Child Care Hospital between July1^st,2012 and June 30^th,2018.Variance analysis was used to compare the platelet and coagulation parameters in the third trimester of pregnancy among three groups.Logistic models were used to estimate the odd ratios（ORs）and 95%confidence intervals（CIs）for the correlation of platelet and coagulation parameters in the third trimester of pregnancy with HELLP Syndrome.And the ROC curve was used to assess the values of platelet and coagulation parameters for diagnosing HELLP Syndrome.Results1.Compared with preeclamptic and control groups,PLT decreased while PCT increased in HELLP syndrome group.The differences were statistically significant（P<0.001）.There was no significant difference in PLT and PCT between preeclamptic and control group（P>0.05）.PDW in HELLP syndrome group was larger than that in preeclampsia group,which was higher than that in control group.The differences were statistically significant(（P<0.05）.There was no significant difference in MPV among the three groups.2.Compared with preeclamptic and control groups,PT decreased in HELLP syndrome group.The differences were statistically significant（P<0.05）.There was no significant difference in PT between preeclamptic and control group（P>0.05）.PTA、Fib and D-D in HELLP syndrome group was larger than that in preeclampsia group,which was higher than that in control group.The differences were statistically significant(（P<0.05）.There was no significant difference in APTT and TT among the three groups（P>0.05）.3.In the multivariate-adjusted Logistic models,higher PLT and PT were protective factors for HELLP syndrome,and the ORs were 0.980（95%CI 0.970-0.980）and 0.440（95%CI0.260-0.680）,respectively.While higher PDW,PCT,PTA,TT,Fib,and D-D were risk factors for HELLP syndrome,and the ORs of HELLP were 1.230（95%CI 1.020-1.500）,1.170（95%CI 1.040-1.130）,1.010（95%CI 1.010-1.020）,3.370（95%CI 2.280-4.980）,1.030（95%CI 1.020-1.040）and 1.280（95%CI 1.160-1.420）,respectively.ROC curve was used to analyze the diagnostic value of platelet and coagulation parameters in the third trimester of pregnancy in HELLP syndrome.The largest areas under the ROC curve were PLT and D-D,and the AUCs were 0.903（P<0.01）and 0.858（P<0.01）,respectively.ConclusionPlatelet and coagulation parameters in the third trimester of pregnancy were correlated with HELLP syndrome.PLT and D-D have certain value in diagnosis of HELLP syndrome,which benefits for early diagnosis and early intervention to improve perinatal maternal and fetal outcomes.