1
INTRODUCTION
There are many changes in anatomy, physiology and biochemistry
in pregnant women which result from fetus and placenta development.
Although these changes are physiological but sometimes they can cause
dangerous complications for the mother and the fetus also. So we need
to discuss more on their physiological changes, include coagulation
system, in order to manage pregnancy more effectively.
In obstetrics, good hemostasis minimizes obstetric complications,
especially postpartum haemorrhage. These complications account for
30% of the causes of death in pregnant women in Africa and Asia.
Maternal death rates for postpartum hemorrhage accounted for 3.4% in
the UK between 2006 and 2008, and 11.4% in the United States
between 2006 and 2010. Coagulation tests help regulate prenatal blood
coagulation disorders, which help diagnose and treat bleeding
complications during and after birth.
Studies that adequately describe the change in hemophilia during
pregnancy have not been performed. In particular, studies with
predictive values for some of the variations in hemophilia screening
parameters during pregnancy and childbirth have not been reported.
Objectives of the study:
1. To discribe some coagulation indexes in pregnant women in
three trimesters.
2. To discribe the change of coagulation indexes during pregnancy
and correlation with some characteristic of pregnant women.
NEW CONCLUSIONS OF THE THESIS:
1. There was a hypercoagulation state in pregnant women in
comparison with non-pregnant women.
2. Hypercoagulation state increasing gradually from the first
trimester to the labor.
3. There were correlation between average platelet count and
gestation age, average plasma fibrinogen concentration and
gestation age, pregnant women’ BMI and plasma fibrinogen
concentration..
4. Decreasing platelet count and shortening APTT were risk
factors of preeclampsia.
2
LIST OF THESIS
The dissertation is 114 pages long with 4 chapters, 23 tables, 20 charts
and 138 references in the order shown in the thesis. The dissertation is
structured as follows: Problem: 2 pages. Chapter 1: Overview of Materials
(33 pages). Chapter 2: Objectives and Methods (9 pages). Chapter 3:
Results (30 pages). Chapter 4: Discussion (37 pages). Conclusion: 2 pages.
Recommendation: 1 page.
Chapter 1: BACKGROUND
1.1. Physiological process of stopping the blood
1.1.1. Stage bleeding head
There are two mechanisms involved in the initial hemostasis: local
vasoconstriction and platelet aggregation.
1.1.1.1. Factors involved in hemostasis are head
- Blood vessel; Platelet; adhesion proteins; Fibrinogen.
1.1.1.2. Mechanism of bleeding head
Occurs only when the wall of the lesion exposes the lower
subsection, the platelets stick to the subarachnoid in the presence of
vWF and the GPIb receptor on the platelet surface. Globally, they
release ADP products, serotonin, and epinephrine. They promote the
clotting of platelets, platelets that stick together and enter the subcutis,
after a few minutes. Thrombocytopenia where blood vessels are injured.
This is a complex process with vasoconstriction, platelet aggregation,
release reactions, platelet aggregation, and coagulation.
1.1.2. Stage of plasma coagulation
Plasma coagulation can be divided into three periods with the
involvement of plasma coagulation factors: Activated thromboplastin
(prothrombinase complex) by endogenous and exogenous pathways,
thrombin formation, Formation of fibrin.
1.1.3. Fibrinolysis phase
The basic purpose of this phase is to dissolve the fibrin back to the
ventilation of the artery wall, which consists of two processes: blood
clotting and thrombosis.
1.1.4. Physiological coagulation inhibitors
Coagulation inhibitors: divided into two groups, serine protease
and S, C, thrombomodulin.
3
1.2. Some coagulation tests and clinical significance
1.2.1. Count platelet counts: Platelet count decreased as a result of
<150 g / l. Platelet count increased as a result of> 400G / l.
1.2.2. Duration of activated thromboplastin (APTT: Activited Partial
Thromboplastin Time): The shortened APTT reflects endometrial
hyperplasia. To evaluate blood coagulation factors by endogenous
pathway. Evaluation of results: r = APTT disease (seconds) / APTT
certificate (seconds), normal: 0.8 to 1.25.
1.2.3. Prothrombin Time (PT) (Time Quick) This test evaluates all
factors of exogenous coagulation (factors II, V, VII, X). PT% normal:
70- 140%.
1.2.4. Quantification of fibrinogen:
Evaluation: Normal fibrinogen concentration: 2-4g / l, decreased by <2g
/ l, increased by> 4g / l.
The above-mentioned indicators are called first line coagulation tests,
which are often used to probe hemodialysis, based on changes in these
indices to indicate probe tests. Follow-up to identify problems related to
coagulation of patients.
1.2.5. Quantitative coagulation factors II, V, VII, X.
Principles: PT testing after providing the necessary components, except
the factors that need to be quantified.
Evaluation of the results: Normal blood coagulation levels ranged from
60 to 140% in comparison with normal plasma samples.
1.2.6. Quantitative coagulation factor VIII, IX, XI, XII.
Principle: Test the APTT after providing the necessary components,
except the factors that need to quantify.
Evaluation of results: Normal levels of factors VIII, IX ranged from
50% to 180% compared with normal plasma samples.
1.3. The stages of pregnancy and the response of the mother body
during pregnancy
The stages of pregnancy
The first quarter is from the onset of embryonic development until
14 weeks of gestation. The second quarter from the 14th week to the
end of the 28th week of pregnancy. Quarter III: From the 29th week to
the 40th week of pregnancy.
4
1.3.2. The response of the mother body during pregnancy
1.3.2.1.Human response
Hormonal changes are most important, leading to many other changes
in the body of the sex.
1.3.2.2. Hematological response.
The mother's blood system must increase its ability to function both in
blood volume and circulation. Elevated clotting factor, fibrinolytic and
platelet decreased.
1.3.2.3. Response of some other organ systems.
Cardiovascular system: increased cardiac output, blood vessels and
lengthening, blood pressure changes not significant.
Metabolic response: increased assimilation, insulin resistance, elevated
cholesterol, low density lipoprotein, reduced protein and total albumin.
1.3.2.4. The placenta and the role of placenta in the mechanism of
bleeding in pregnant women. The pie is about 15 cm in diameter,
weighs 1/6 of the fetal weight (about 400-500 grams), 2.5-3 cm thick,
and is thinner in the periphery. The special structure of vegetable cakes
requires a fast, effective coagulation mechanism and coagulation in
place. The presence of blood coagulation precursors and anticoagulants
in endothelial and vascular endothelial cells is a major component of
hemostasis. Coagulation activation is a predominant process expressed
in elevated fibrin levels. Vegetable cakes are the source of many
coagulant production.
1.4. Species of scientific diseases
1.4.1. Bleeding after delivery Postpartum hemorrhage is the leading
cause of maternal mortality in underdeveloped areas, including Vietnam.
In order to prevent postpartum hemorrhage, it is important to ensure that
the mother is healthy, has no anemia, and has a blood clotting disorder, is
not excessively pregnant, is carefully monitored for prolonged periods of
time, The amount of blood delivered at birth is accurate to intervene
promptly and alertness to postpartum haemorrhage may occur
1.4.2. Preeclampsia (TSG) Preeclampsia is a condition caused by
pregnancy in the second half of pregnancy, which begins as early as 21
weeks of gestation. This disease is usually manifested with syndrome
consisting of 3 main symptoms: hypertension (THA), proteinuria and
edema. Pregnant women are diagnosed with TSG at gestational age of
20 weeks or more, have a blood pressure of 140/90 mm Hg or higher,
proteinuria 24 hours per 300mg.
5
Chapter 2: OBJECTIVES AND RESEARCH METHODS
2.1. research design
2.1.1. A cross-sectional descriptive study of pregnant women in
pregnancy.
- Research subjects: Study Team: 754 women who go to the clinic and
have a pregnancy management at Hanoi Obesity Hospital in 2012 and
2013, divided into 3 groups:
Group 1: Pregnant women with gestational age less than 14 weeks (first
trimester).
Group 2: Pregnant women 14 to 28 weeks (mean three months). Group
3: Pregnant women with gestational age of 29 weeks or more (last three
months).
- The number of subjects in each group is calculated according to the
following formula:
11-0,3
n= Z21-α/2 2 =1,962
=224
ε
0,22x 0,3
+ n is the number of samples to be taken for each study group.
+ p is the rate of postpartum hemorrhage of reference study
+ ε is the relative error of choice ε by 0.2
+ Z2-1-α / 2 with α is chosen as 0.05
Thus, the sample size required for each group was 224 pregnant
women. In fact, we included 261 pregnant women in the first group,
255 in the second group and 238 women in the third group.
Control group: Includes 75 healthy healthy women of childbearing age
(15-49 years), not pregnant, with the same age group as the research
group. There is no history of blood clotting disorders, no medications
can affect blood clotting.
Exclusion criteria: Exclusion from the study group of pregnant women:
conditions associated with congestive hemorrhagic congestion; pregnant
women who are treated with drugs that interfere with blood clotting and
those who are pregnant and disagree to participate in research.
2.1.2. Longitudinal follow-up study, the self-control comparison for
pregnant women, was monitored for coagulation outcomes during
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pregnancy.
Pregnant women who have a primary blood coagulation test in
pregnancy 1 (gestational age 9-12 weeks) within the normal range are
followed for pregnancy 2 (gestational age 23-26 weeks), pregnancy 3
(34-37 weeks) and labor. The results are intended to describe some of
the effects of coagulation during pregnancy.
- The number of objects of this group is calculated according to the
following formula:
In the formula:
+ n is the number of samples needed for the research team.
+ p is the rate of postpartum hemorrhage of reference study
+ d desired level of deviation, choose 0.15
+ Z2-1-α / 2 with α is chosen as 0.05 In fact, we conducted a follow-up
of 47 women with normal coagulation scores selected from group 1 of
the study described above.
2.1.3. Case - control study of coagulation index in preeclampsia
women and healthy pregnant women.
Among subjects, 16 women had pre-eclampsia. Thus, we
conducted a case-control study with 16 pre-eclampsia patients, the
control group of 64 women belong to group 3 with gestational age
equivalent to pre-eclampsia ones.
Pregnant women with a blood pressure of 140 / 90mmHg or higher,
proteinuria 24 hours per 300mg, are diagnosed by obstetricians. The
preeclampsia level was diagnosed seriously when systolic blood pressure
was 140-159 mmHg and diastolic blood pressure was 90-109 mmHg.
2.2. Research indexes:
* General information: Maternal age, gestational age, height, weight,
BMI of pregnant women. Diabetes mellitus: diabetes mellitus,
hypertension, preeclampsia ... Pregnancy order: 1st, 2nd, 3rd ...
Pregnancy: prenatal, fetal, abortion ...
* Hemostasis indexes: Blood clotting index: SLTC, PT, APTT,
plasma fibrinogen. Quantitative active of coagulation factors II, V,
7
VII, VIII, IX, X, XI, XII
2.3. Research protocol:
- Physical examination: selected subjects, general clinical
examination, obstetric clinic at Hanoi Obstetrics Hospital.
- Blood Collection: Each blood collection took two tubes: an
EDTA blood sample tube for blood cell testing, an anticoagulant tube
with sodium citrate for blood clotting. Laboratory techniques are being
applied in the procedure of blood transfusion in Bach Mai Hospital.
2.4. Research equipments.
- Blood Machine: CA 1500 of Sysmex company of Japan. Automatic
cell counting machine: XT 1800i from Sysmex of Japan.
2.5. Laboratory techniques and evaluation criteria:
Laboratory techniques were performed and results were evaluated
according to the procedures being applied at the Department of
Hematology, Bach Mai Hospital.
* Count of platelets
* Duration of activated thromboplastin (APTT: Activated Partial
Thromboplastin Time)
* Time prothrombin (Prothrombin Time: PT) (Quick time)
* Fibrinogen quantitative
* Quantitative coagulation factor II, V, VII, X.
* Quantitative coagulation factor VIII, IX, XI, XII.
2.6. Data analyse:
* The above data are processed according to medical statistical method
on STATA 12.0 program.
* Description of results:
- Quantitative variables are expressed in terms of mean and standard
deviation (± SD).
- Qualitative variables are presented in percentages.
- OR calculation to determine risk factors for pre-eclampsia.
* Evaluating differences between pregnant women and control groups:
Comparison of mean values for two independent groups: T-test, Mann
Whitney test or Kruskal Walis test.
Using a multivariate linear regression model to determine the
relationship between coagulation outcomes and maternal and fetal
outcomes:
- Relationship between gestational age and SLTC, with fibrinogen.
- The relationship between PT and activity factors II, V, VII, X.
- The relationship between APTT and activity factor VIII, IX, XI, XII.
8
- The relationship between plasma fibrinogen and BMI of group 3
pregnant women.
* Dealing with missing data during pregnancy monitoring:
In the study, there was a certain percentage of pregnancies in the
follow-up group who did not continue to participate in the study at later
stages of pregnancy. The phenomenon of missing the common
denominator (missing) is quite common in clinical medical studies for
various reasons.
In view of this fact, statisticians around the world have proposed a
statistical / regression model to predict the missing values from the
relevant variables, the English statistical term described. is "multiple
imputation". The main purpose of this statistical method is to reduce and
eliminate subjective errors caused by the deletion of records and missing
values in the dataset. Statistical software will generate "m" sets of missing
value estimates. For each dataset, the value of the missing variable is
randomly included in the statistical model based on the distribution of the
dataset. The estimated final value of the missing value is the estimated
average value from "m" of the estimated missing data set.
This is a well-evaluated method that is commonly used in medical
monitoring studies: a) the results of the analysis are not misleading; b)
using all variables, ensuring sample size and statistical power; c) can be
used on many standard statistical software; d) easy to interpret results. The
only downside to this approach is the reduction in variance / standard
deviation of the variable. Based on the "multiple imputation" approach, the
data of the pregnant women followed in this study included 47 subjects,
although some women did not continue to participate in the study at other
times. (Figure 2.1).
Figure 2.1: Number of women participating in follow-up studies
2.7. Research ethics.
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The research is part of a city-level research project "Studying some
coagulation parameters in healthy women in childbearing age and
pregnant women in Hanoi" was conducted from January 2012 to
December. in 2013, has been approved by the medical ethics committee of
the Hanoi Obstetrics Hospital. All subjects were given a clear explanation
of the purpose, methods of conducting the study and volunteered to
participate in this study. All information collected confidentiality for
patients, only for research purposes. Based on the results of the study, the
choice of information is useful for the treatment and counseling of patients,
only for the purpose of protecting and improving the health of the patient,
for no other purpose.
Chapter 3: RESULTS
3.1. The results of a cross-sectional descriptive study on
the characteristics of some pregnancy coagulation
parameters in pregnancy:
3.1.1. Describe some characteristics of the research object:
3.1.2. The results of a cross-sectional descriptive study on the
characteristics of some pregnancy coagulation parameters in
pregnancy:
3.1.2.1. Coagulation indexes in first trimester women (group 1).
Table 3.1. The average first line coagulation in group 1.
Index
Unit
Platelet count
Fibrinogen
PT
PT%
INR
APTT
rAPTT
G/L
g/L
Second
%
Second
Group 1 (n=261)
Control (n=75)
( X ±SD)
228.66±49.53
3.45±0.53
11.55±0.74
101.61±12.35
0.99±0.06
27.96±1.33
0.96±0.07
( X ±SD)
248.87±36.70
2.71±0.36
11.65±0.50
99.91±9.10
1.00±0.04
28.23±1.63
1.05±0.06
p
<0.001**
<0.001**
>0.05
<0.005*
>0.05**
<0.01**
<0.001**
Table 3.2. The average coagulation factor activity in group 1.
Index
Group 1 (n=84)
Control (n=75)
p
10
( X ±SD)
96.16±19.92
74.88±19.92
87.66±23.08
69.41±27.37
74.56±18.18
97.88±21.23
88.21±57.66
56.91±28.67
FII (%)
FV (%)
FVII (%)
FVIII (%)
FIX (%)
FX (%)
FXI (%)
FXII (%)
( X ±SD)
110.86±13.52
107.2±13.52
97.83±22.29
82.51±23.17
62.24±11.40
101.59±22.43
95.65±14.79
58.73±20.87
<0.001
<0.001
<0.01
<0.01
<0.05
>0.05
<0.05
>0.05
3.1.2.2. Coagulation indexes in second trimester women (group 2).
Table 3.3. The average first line coagulation in group 2.
Index
Unit
Platelet count G/L
Fibrinogen
g/L
PT
second
PT%
%
INR
APTT
second
rAPTT
Group 2 (n=255)
Control (n=75)
( X ±SD)
216.55±47.83
3.68±0.48
11.22±0.64
107.48±12.28
0.97±0.06
27.47±2.18
0.94±0.08
( X ±SD)
248.87±36.7
2.71±0.36
11.65±0.50
99.91±9.10
1.00±0.04
28.23±1.63
1.05±0.06
p
<0.001**
<0.001**
<0.01**
<0.001*
<0.01**
<0.001**
<0.001**
Table 3.4. The average coagulation factor activity in group 2.
Index
FII (%)
FV (%)
FVII (%)
FVIII (%)
FIX (%)
FX (%)
FXI (%)
FXII (%)
Group 2 (n=83)
Control (n=75)
( X ±SD)
98.5±17.99
68.9±28.06
140.84±41.05
90.53±35.05
81.3±23.38
117.79±29.48
90.15±10.67
80.67±39.11
( X ±SD)
110.86±13.52
107.2±13.52
97.83±22.29
82.51±23.17
62.24±11.40
101.59±22.43
95.65±14.79
58.73±20.87
p
<0.001
<0.01
<0.001
>0.05
<0.001
<0.001
<0.001
<0.001
3.1.2.3. Coagulation indexes in third trimester women (group 3).
Table 3.5. The average first line coagulation in group 3.
Index
Unit
Group 3
(n=238)
Control (n=75)
p
11
Platelet count
Fibrinogen
PT
PT%
INR
APTT
rAPTT
G/L
g/L
Second
%
Second
( X ±SD)
204.81±62.45
4.04±0.30
11.06±0.81
111.20±14.31
0.95±0.02
27.63±1.99
0.94±0.03
( X ±SD)
248.87±36.70
2.71±0.36
11.65±0.50
99.91±9.10
1±0.04
28.23±1.63
1.05±0.06
<0.001**
<0.001**
<0.01**
<0.01*
<0.01**
<0.001**
<0.01**
Table 3.6. The average coagulation factor activity in group 3.
Group 3 (n=90)
Control (n=75)
p
Index
( X ±SD)
( X ±SD)
FII (%)
91.37±15.95
110.86±12.03
<0.001
FV (%)
76.45±31.01
107.2±13.52
< 0.05
FVII (%)
149.67±50.68
97.83±22.29
<0.001
FVIII (%)
119.70±53.61
82.51±23.17
<0.001
FIX (%)
108.50±26.67
62.24±11.40
<0.001
FX (%)
130.46±49.54
101.59±22.43
<0.001
FXI (%)
88.32±34.80
95.65±14.79
<0.05
FXII (%)
124.16±60.54
58.73±20.87
<0.001
3.2. Longitudinal study results of some coagulation parameters in
pregnancy and correlation with some characteristics of pregnant
women.
3.2.1. Longitudinal study results of some coagulation parameters in
pregnancy.
3.2.1.1. The change in platelets count through pregnancy
12
220
G/L
210
200
**
**
190
180
170
160
Thai kì 1
Thai khì 2
Thai kì 3
Chuyển dạ
Figure 3.1. The change of the average platelet count during
pregnancy.
13
s
3.2.1.2. The change of PT through pregnancy
12
11.8
**
***
11.6
11.4
11.2
11
10.8
10.6
Thai kì 1
Thai khì 2
Thai kì 3
Chuyển dạ
Figure 3.2. The change of the average PT index during pregnancy.
3.2.1.3. The change of APTT through pregnancy
28
s
27.8
27.6
*
*
*
27.4
27.2
27
26.8
26.6
Thai kì 1
Thai khì 2
Thai kì 3
Chuyển dạ
Figure 3.3. The change of of the APTT during pregnancy.
3.2.1.4. The change of plasma fibrinogen concentration through
pregnancy
g/l
5
***
**
4
**
3
2
1
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển dạ
14
Figure 3.4. The change of plasma fibrinogen concentration through
pregnancy
3.2.1.5. The change of activity of coagulation factors through
pregnancy
%
120
100
80
*
*
***
60
40
20
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển dạ
Figure 3.5. The average activity Factor II through pregnancy
%
100
80
**
***
*
60
40
20
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển d ạ
Figure 3.6. The average activity Factor V through pregnancy
%
15
250
200
150
**
***
*
100
50
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển d ạ
Figure 3.7. The average activity Factor VII through pregnancy
150
%
*
130
***
110
90
***
70
50
30
10
Thai kì 1
-10
Thai kì 2
Thai kì 3
Chuyển d ạ
Figure 3.8. The average activity Factor VIII through pregnancy
%
140
120
***
100
***
80
*
60
40
20
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển d ạ
16
Figure 3.9. The average activity Factor IX through pregnancy
%
***
140
***
120
100
***
80
60
40
20
0
Thai kì 1
Thai kì 2
Thai kì 3
Chuyển d ạ
Figure 3.10. The average activity Factor X through pregnancy
%
100
90
80
70
60
50
40
30
20
10
0
Thai kì 1
**
Thai kì 2
*
Thai kì 3
Chuyển d ạ
Figure 3.11. The average activity Factor XI through pregnancy
%
180
160
140
120
100
80
60
40
20
0
Thai kì 1
***
***
Thai kì 2
Thai kì 3
Chuyển d ạ
Figure 3.12. The average activity Factor XII through pregnancy
Number of subject
17
22
25
20
14
15
15
10
5
3 2
6
6
3 2
5 4
0
0 0er 0 0
r0
r
te
te
t
es
es
es
m
m
rim
tri
tri
tt
d
d
s
r
n
i
r
Fi
co
Th
Se
r
bo
La
Low platelet
PT shortening
APTT shortening
High Fibrinogen
Figure 3.13. Number of pregnant women who change their first line
coagulation parameters through pregnancy
3.2.2. Relationship between some coagulation parameters and some
maternal characteristics.
3.2.2.1. Comparison of primary coagulation and active blood
coagulation factors between first and second pregnancy.
3.2.2.2. Relationship between some coagulation parameters and
maternal and fetal characteristics and pregnancy outcomes.
* Relationship between gestational age and platelet count:
Platelet count = 294,888 – 27,872 * log (gestation age)
p<0,001
R2 = 0,41
* Relationship between gestational age and fibrinogen:
Fibrinogen = 12,967 + 0,2609 * log (gestation age)
p<0,001
R-squared = 0,52
* Relationship between PT and activity factors II, V, VII, X:
PT = 12,0836 -0,00126 *II - 0,000898 *V - 0,41 *VII + 0,0017 *X
p<0,0001
R-squared = 0,69
* Relationship between APTT and activity factors VIII, IX, XI, XI
18
APTT = 29,869 – 0,03415 *VIII – 0,0169 *IX + 0,00014 *XI +
0,00587 *XII
p<0,001
R-square = 0,38
* Relationship between plasma fibrinogen and BMI in group 3:
Fibrinogen = 3,11 + 0,035 x BMI
3.2.3. Results of a case-control study on risk factors of preeclampsia.
While recruited the group 3 study, we collected 16 women with
mild pre-eclampsia. Pregnant women in the hospital for the first time
during pregnancy. Prior to that, they only came to the clinic for a fetal
ultrasound. We selected 64 women from Group 3 as controls (1/4), the
standard of pregnant women included in the control group was that
women with gestational age were equivalent to women with mild
preeclapsia. The number of pregnant women in the preeclampsia group
and the control group by gestational age is shown in Table 3.18.
19
Table 3.18. Number of pregnant women in the preeclampsia group and
control group by gestational age
Gestation week (week)
31
34
36
37
Total
Preeclampsia
1
6
4
5
16
Control
4
24
16
20
64
Table 3.19. Test results of some clotting index of pregnant women in the
last three months had preeclampsia.
Control (n=64)
Unit
Preeclampsia
(n=16)
Platelet count
G/L
( X ±SD)
167.10 31.10
( X ±SD)
216.17±16.22
Fibrinogen
g/L
2.94 0.82
3.16±0.63
PT
Second
10.67 0.86
10.88±0.70
PT%
%
128.8 22.70
122.6±20.05
0.89 0.08
0.92±0.04
26.01 0.90
28.32±1.72
0.83 0.06
0.96±0.12
Index
INR
APTT
Second
rAPTT
p
<0.0
1
<0.0
5
>0.0
5
>0.0
5
>0.0
5
<0.0
5
<0.0
5
Table 3.21. Relationship between low platelet count and preeclampsia.
Preeclampsia
Control
Total
Low platelet count
10
5
15
Non - low platelet count
6
59
65
Total
16
64
80
OR= 10x59/5 x 6 = 19.6
20
Table 3.21 shows that pregnant women with a low platelet count were
19.6 times more likely to develop preeclampsia than Non - low platelet
count ones.
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