妊娠期抗生素对止血参数的影响

Iyevhobu Kenneth Oshiokhayamhe, R. A. Amaechi, A. Turay, T. Okobi, E. Usoro, B A Ken-Iyevhobu
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摘要

估计每年有50,000名尼日利亚妇女死于妊娠和分娩并发症,占全球妊娠孕产妇死亡估计数的10%,其中约2%死于药物诱导。本横断面研究旨在评估在江户州贝宁市Oredo卫生中心产前诊所就诊的孕妇的凝血酶原时间试验(PT)、活化部分凝血活酶时间试验(aPTT)、红细胞沉降率(ESR)和血小板计数(PC)。研究共招募了130名受试者,其中包括100名孕妇和30名非孕妇。采用标准手工方法测定凝血酶原时间(PT)、活化部分凝血活素时间(APTT)、血小板计数和红细胞沉降率(ESR)。孕早期凝血酶原时间(19.12±0.77b)、妊娠中期(19.90±1.02 b)、妊娠晚期(19.66±0.56 b)、激活部分凝血酶时间(sec)、妊娠中期(44.02±1.17 b)、妊娠中期(47.72±1.47 b)、妊娠晚期(45.88±1.10b)、红细胞沉降(mm/hr)、妊娠中期(24.37±3.04 a)、妊娠中期(37.83±4.53 a)、妊娠晚期(43.25±5.24 a)、血小板计数(X109/L)、妊娠早期(248.29±23.18a)。妊娠2期(236.33±13.84 b)和妊娠3期(239.10±16.07 a)明显高于非妊娠妇女凝血酶原时间(16.48±0.81 a)、活化部分凝血活素时间(36.53±1.42 a)、ESR (mm/hr)(29.83±4.14 a)和血小板计数(X109/L)(201±9.54 an) (p<0.05)。妊娠晚期的ESR (mm/hr)(43.25±5.24)明显高于妊娠晚期(24.37±3.04)和妊娠晚期(37.83±4.53)(p<0.05)。本研究发现妊娠期抗生素对PT、ESR、APTT和PC均有不良影响。我们建议孕妇在整个妊娠过程和事件中给予应有的关注,以预防或降低血栓性发作和可能的弥散性血管内凝血(DIC)的风险,从而获得更好的母婴安全和健康结果,并就抗生素对妊娠的影响进行教育。
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Effects of Antibiotics on Haemostatic Parameters during Pregnancy
An estimated 50,000 Nigerian women die each year from complications of pregnancy and childbirth, accounting for 10% of global estimates of pregnancy maternal death with about 2% resulting from drug induction. This cross-sectional study sets out to evaluate the Prothrombin time test (PT), activated partial thromboplastin time test (aPTT) Erythrocyte sedimentation rate (ESR), and Platelet count (PC) of pregnant women attending antenatal clinics at Oredo Health Centre in Benin City, Edo State. A total number of 130 subjects comprising 100 pregnant women and 30 non-pregnant women were recruited for the study. Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Platelet count and Erythrocyte Sedimentation Rate (ESR) were studied using standard manual methods. The prothrombin time (sec) of the pregnant women 1st trimester (19.12±0.77b), 2nd trimester (19.90±1.02 b) and 3rd trimester (19.66±0.56 b), activated partial thromboplastin time (sec) 1st trimester (44.02±1.17 b), 2nd trimester (47.72±1.47 b) and 3rd trimester (45.88±1.10b), Erythrocyte sedimentation rate (mm/hr) 1st trimester (24.37±3.04 a), 2nd trimester (37.83±4.53 a) and 3rd trimester (43.25±5.24 a) and platelet count (X109/L) 1st trimester (248.29±23.18a), 2nd trimester (236.33±13.84 b) and 3rd trimester (239.10±16.07 a) were significantly higher than the prothrombin time (sec) 16.48±0.81 a, activated partial thromboplastin time (sec) 36.53±1.42 a, ESR (mm/hr) 29.83±4.14 a and platelet count (X109/L) 201±9.54 an of the non-pregnant women (p<0.05). The ESR (mm/hr) of the 3rd trimester (43.25±5.24) was observed to be significantly higher than that of the 1st trimester (24.37±3.04) and 2nd trimester (37.83±4.53) (p<0.05). Our investigation showed that antibiotics in pregnancy have a deleterious effect on PT, ESR, APTT and PC studied. We recommend that pregnant women should be given due attention throughout the course and events of pregnancy to prevent or reduce the risk of thrombotic episodes and possible disseminated intravascular coagulation (DIC) with resultant better maternity/child safety and health outcome and educated on the effects of antibiotics to pregnancy.
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