Clinical Analysis of 130 Thrombocytopenia in Pregnancy / 中国医师杂志

ABSTRACT

Objective To explore the causes, management and outcome of pregnant women with thrombocytopenia. Methods Medical records from 1999 to 2003 were reviewed for diagnosis,treatment ,and neonatal outcome in 130 women with thrombocytopenia in Xinhua Hospital. Results Thrombocytopenia was mainly caused by prenancy-associated thrombocytopenia (PAT) in 94 (72 3%) cases,idiopathic thrombocytopenia(ITP) in 12 cases (9 2%),hepatic disease in pregnancy in 11 (8 5%)cases, pregnancy induced hypertension 10 cases and preeclampsia 4 (10 8%)cases, Rhesus isoimmunization and viral infection each 1(0 8%) case. Thrombocytopenia was identified initially at 17 +4 weeks of gestation,37 (28 5%) cases were found before 28 weeks,93 (71 5%) cases were found after 28 weeks. Prednisone was considered if the platelet count was less than 50,000/uL. Platelet transfusion was given to those with platelet count less than 50,000/uL before and after delivery. If the platelet count was less than 50,000/uL esarean delivery might be performed. The occurrence of postpartum hemorrhage was 2 3%. Bleeding occurred in two neonatals. One newborn suffered from cephalohematoma. Sixty-three cases PAT recovered spontaneousely within 1 week after delivery. Conclusion Pregnancy thrombocytopenia usually becomes evident in the third trimester. PAT is the most common type of thrombocytopenia during pregnancy. Pregnancy thrombocytopenia is not associated with bleeding diathesis in the mother. Degree of thrombocytopenia with complication was more severe(platelet count usually less than 70,000/uL). Half of ITP are symptomatic. Glucocorticoid is effective treatment for severe thrombocytopenia. Platelet transfusion may be considered when platelet count is still less than 50,000/uL before operation. Mother with ITP may affect infant.Besides therapy directing at the eiology, corticosteroids and platelet transfusion are effective treatment for severe thrombocytopenia during delivery. One half women return to a normal platelet count within one week after delivery.