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| Clinical Efficacy of Aspirin combined with Low Molecular Weight Heparin in the treatment of Fetal Growth Restriction and its Influence on Fetal Blood Flow Parameters and Maternal and Infant Outcomes |
| CHEN Yongli |
| Shiyan People's Hospital of Hubei / Hubei Medical College Affiliated People's Hospital, Hubei Shiyan 442000, China |
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Abstract Objective: To investigate the clinical curative effect of aspirin combined with low molecular weight heparin (LMWH) in the treatment of fetal growth restriction (FGR) and the influence on fetal blood flow parameters and maternal and neonatal outcomes. Methods: 180 pregnant women with FGR caused by umbilical cord and placental abnormalities were divided into the study group (100 cases) and the control group (80 cases) according to different regimens. The situation of fetal development was determined after admission and confirmed diagnosis and was monitored. The control group was treated by subcutaneous injection of LMWH preparation Low Molecular Weight Heparin Calcium Injection. On the basis, the study group was treated with oral Aspirin Enteric-coated Tablets. According to the results of color Doppler ultrasonography, the curative effect was evaluated. The parameters of umbilical artery, such as fetal pulsatility index (PI), resistance index (RI), peak systolic blood flow velocity (S) and peak diastolic end blood flow velocity (D) were detected. Maternal and neonatal outcomes were statistically analyzed. Results: The total effective rate of treatment in the study group was significantly higher than that in the control group (79.00% vs 65.00%) (P<0.05). PI, RI and S/D of the two groups were close before treatment (P>0.05), but they were significantly decreased after treatment, and the decrease in study group was significantly greater than that in the control group (P<0.05). The incidence rates of placental abruption, fetal distress, neonatal asphyxia, premature infants and extremely low birth weight infants in the study group were slightly lower than those in the control group (P>0.05). Conclusion: Aspirin combined with LMWH can effectively improve the fetal blood flow parameters and improve the clinical curative effect on FGR to a certain extent. However, the improvement of curative effect and maternal and neonatal outcomes is limited.
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[1] 汪萍,单腾飞.低分子肝素联合硫酸镁治疗胎儿生长受限的临床效果及可行性[J].中国妇幼保健,2017,32(17):4171~4173.
[2] 孟茜,陈海霞,孙波,等.胎儿生长受限VEGFA和VEGFR2在胎盘中的表达[J].中国妇产科临床杂志,2016,17(3):241~243.
[3] 芮璨,宋学静,龙伟.低分子肝素治疗子痫前期合并胎儿生长受限对妊娠结局的影响[J].江苏医药,2015,41(16):1887~1890.
[4] 张高,程玲慧.低分子肝素与小剂量阿司匹林联合可有效治疗复发性流产[J].基因组学与应用生物学,2017,36(4):1348~1354.
[5] Schisterman E F, Silver R M, Lesher L L, et al. Preconception low dose aspirin and pregnancy outcomes: findings from the EAGeR (effects of aspirin in gestation and reproduction) randomized trial[J]. American Journal of Obstetrics & Gynecology, 2015, 100(5):1785~1791.
[6] 乐杰,谢幸.妇产科学[M].第7版.北京:人民卫生出版社,2008.401.
[7] Kafkasli A, Turkcuoglu I, Turhan U. Maternal, fetal and perinatal characteristics of preeclampsia cases with and without abnormalities in uterine artery doppler indexes[J]. Journal of Maternal-Fetal Medicine, 2013, 26(9):936~940.
[8] 李云端,刘伟武,徐秀英.影响临床胎儿生长受限的多因素分析及预防措施[J].实用临床医药杂志,2017,21(1):90~93.
[9] 袁燕,郑九生.低分子肝素在产科应用中的研究进展[J].现代妇产科进展,2016,25(8):631~632.
[10] 梁蓉,石通和,刘淑芳,等.阿司匹林联合低分子肝素治疗血栓前状态致早期复发性流产的效果评价[J].中国现代医生,2014,52(16):63~65.
[11] Nazari Z, Ghaffari J, Ebadi A. Comparison of the effect of aspirin and heparin with or without intravenous immunoglobulin in treatment of recurrent abortion with unknown etiology: a clinical study[J]. Journal of Natural Science Biology & Medicine, 2015, 6(1):17~21. |
| [1] |
. [J]. 河北医学, 2017, 23(6): 1035-1037. |
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2019, Vol. 25 
