增强产期静血管理不会降低血友病携带者产后出血发生率:怀孕和遗传出血障碍研究 (PRIDES)
A de Vaan1, Mjha Kruip2, J Eikenboom3
1Center for Benign Haematology, Thrombosis and Haemostasis, van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Journal of thrombosis and haemostasis : JTH
|March 9, 2026
概括
荷兰对孕妇血友病携带者的修订指南没有降低严重产后出血 (PPH) 率. 增加因子值为<80 IU/dL和≥150 IU/dL并没有阻止PPH,这表明需要进一步研究.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 生殖医学 生殖医学
背景情况:
- 患有严重产后出血 (PPH) 风险的孕妇血友病携带者接受预防性因素缩剂.
- 荷兰的指导方针在2018年进行了修订,以提高第三季度因子值,并由于高PPH率,在分娩期间目标峰值水平.
研究的目的:
- 在2018年实施荷兰修订指南后,评估孕妇血友病携带者严重PPH的发病率.
- 为了将严重的PPH率与指南修订之前的历史数据进行比较.
主要方法:
- 荷兰血友病治疗中心对怀孕的血友病携带者 (2018-2024) 的预期招生.
- 记录因子活性,血液学和产科结果.
- 与历史队列 (2012-2017年) 的比较,使用后勤回归来纠正混.
主要成果:
- 严重的PPH发生在170例分娩中的12.4%;没有观察到血栓形成.
- 在第三季度水平<80 IU/dL的载体中,预防PPH率与自发升高>80 IU/dL的载体相似.
- 与历史队列相比,严重的PPH发病率没有下降 (第三季度切断值<50 IU/dL).
结论:
- 将第三季度因子值提高到<80 IU/dL,并在分娩时达到≥150 IU/dL并没有降低血友病携带者的严重PPH风险.
- 需要进一步的研究来确定最佳的凝血因子水平,以预防分娩期间的严重PPH.
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