| Objective: We investigated the effectiveness of the preventive anticoagulant effect of LMWH after cesarean section by observing the differences of various anticoagulant function indexes before and after cesarean section,so as to provide certain clinical auxiliary basis for the prevention and treatment of perinatal high-risk maternal thrombosis.Methods: A randomized controlled trial was conducted,we select 100 high-risk pregnant women who underwent cesarean section in the Department of Obstetrics and Gynecology,our hospital from June 1,2017 to December 31,2017.According to the score of their high risk factors,100 patients with score greater than or equal to 2 were selected as the high risk group.At the same time,100 women without high risk factors were selected as Low-risk group.According to the voluntary principle,pregnant women were randomly divided into high-risk experimental group and high-risk observation group.The high-risk group received subcutaneous injection of low molecular weight heparin calcium（commercial name: limaiqing）12hours after cesarean section,5000 IU,qd,and the course of treatment was 5days.The high-risk observation group was not treated with anticoagulation therapy.D dimer,fibrinogen（FIB）,prothrombin time（PT）,activated partial thrombin activity time（APTT）,platelet（PLT）and hematocrit（HCT）were detected in the blood of the high-risk experimental group and the high-risk observation group before and the four day after cesarean section,respectively.In the low-risk group,venous blood was extracted before delivery to detect the above anticoagulation indexes.To analyze and compare the differences in the amount of vaginal bleeding between the high-risk group and the low-risk group,the high-risk experimental group and the observation group before and after surgery,and the high-risk experimental group and the high-risk observation group 24 hours after cesarean section.Results: 1.D-dimer and FIB in the high-risk group were significantly higher than those in the low-risk group,and the difference was statistically significant（P<0.05）.PT and APTT in the high-risk group were significantly lower than those in the low-risk group,and the difference was statistically significant（P<0.05）.PLT and HCT showed no significant difference between the high-risk group and the low-risk group（P>0.05）.2.For women with high risk factors of VTE in the third trimester of pregnancy,the risk factor level was positively correlated with D-dimer.And the higher the risk factor score was,the higher the d-dimer value was.3.There was no significant difference between the high-risk pregnancy test group and the high-risk observation group before cesarean section anticoagulation indexes（P>0.05）.Comparing the anticoagulation indexes of the two groups after cesarean section,we found that the D-dimer decreased in the high-risk pregnancy test group,which was significant in statistics（P<0.01）,while there was no significant difference in terms of FIB,APTT,PT,PLT and HCT.（P>0.05）.4.There was no significant difference in vaginal bleeding between the high-risk pregnancy group and the high-risk observation group in 24 hours after operation（P>0.05）.Conclusions: 1.The blood of women with high risk factors of venous thromboembolism in late pregnancy is in a state of obvious hypercoagulation.The anticoagulant function D-dimer of women with high risk factors for venous thromboembolism in the third trimester was correlated with the grade of risk factors.Moreover,the anticoagulant function of the prethrombotic state was various with the increase of this grade.2.For women with high risk factors of VTE in late pregnancy,short-term use of prophylactic dose of LMWH after cesarean section can effectively improve the prethrombotic state and no increase the risk of postpartum hemorrhage. |
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