Song T B, Kim E K
Department of Obstetrics and Gynecology, Chonnam National University Medical School, Chonnam National University, Kwangju, Korea.
Haematologia (Budap). 2001;31(1):25-31. doi: 10.1163/15685590151092661.
To define clinical outcomes of marked gestational thrombocytopenia (GT) (<100,000/mm3) we identified twenty-nine infants born to 28 pregnancies at 26 women with GT among 8,364 deliveries during the years 1993- 1999. Cordocentesis was performed in 7 mothers with platelet counts less than 75,000/mm3. Cord blood platelet count was checked in all cases at delivery. The most significant decrease of platelet count in pregnancy with GT was less than 50,000/mm3 in 6 pregnancies (21.4%) and between 50,000 and 100,000/mm3 in 22 pregnancies (78.6%). In pregnancies with GT, 2 neonates (6.9%) had mild thrombocytopenia and 1 neonate (3.4%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with GT. There were no cases of coagulation disturbance at delivery or in the postpartum period. Fourteen cases for which follow-up was carried out recovered platelet counts to more than 100,000/mm3 within one month postpartum. Two patients who became pregnant twice noticed recurrence of GT. In conclusion, GT is not associated with bleeding diathesis in the mother, resolves spontaneously during the postpartum period, and can recur in subsequent gestations, and the association of severe fetal/neonatal thrombocytopenia is very rare. No intervention is necessary during pregnancy or delivery, apart from a careful maternal and fetal surveillance if there is no obstetric indication.
为明确显著妊娠期血小板减少症（GT）（血小板计数<100,000/mm³）的临床结局，我们在1993年至1999年期间的8364例分娩中，确定了26例患有GT的孕妇所生的28胎中的29名婴儿。7名血小板计数低于75,000/mm³的母亲接受了脐血穿刺术。所有病例均在分娩时检查脐血血小板计数。GT孕妇中血小板计数下降最显著的情况为：6例妊娠（21.4%）低于50,000/mm³，22例妊娠（78.6%）在50,000至100,000/mm³之间。在患有GT的妊娠中，2例新生儿（6.9%）有轻度血小板减少症，1例新生儿（3.4%）有中度血小板减少症。GT母亲所生的任何新生儿均未观察到严重血小板减少症。分娩时或产后期间均无凝血功能障碍病例。进行随访的14例病例在产后1个月内血小板计数恢复至超过100,000/mm³。2例两次怀孕的患者出现GT复发。总之，GT与母亲的出血素质无关，在产后期间可自发缓解，且在随后的妊娠中可能复发，严重胎儿/新生儿血小板减少症的关联非常罕见。如果没有产科指征，除了仔细的母胎监测外，孕期或分娩期间无需干预。
