Haram Kjell, Søfteland Eirik, Hervig Tor, Pirhonen Jouko
Kvinneklinikken, Haukeland Universitetssykehus, Bergen.
Tidsskr Nor Laegeforen. 2003 Aug 28;123(16):2250-2.
BACKGROUND, MATERIAL AND METHODS: This paper provides a short review of thrombocytopaenia in pregnancy based on a search in PubMed as well as clinical experience.
Normal platelet count in pregnancy is 250-290 x 10(9)/l, Thrombocytopaenia in pregnancy may be defined as platelet counts below 150 x 10(9)/l. Benign gestational thrombocytopaenia (platelet count 70-150 x 10(9)/l without clinical findings or any maternal or fetal risk) develops in 5%-12% of all pregnancies in the third trimester. Immune thrombocytopaenia (ITP) occurs in about one or two out of 1000 pregnancies and may be complicated by fetal alloimmune thrombocytopaenia. Thrombocytopaenia is present in nearly half of the cases with preeclampsia. The HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low Platelet count) is classified according to platelet counts. Thrombotic thrombocytopenic purpura (TTP), haemolytic uremic syndrome (HUS) and fatty liver may imply low platelet counts. Infections, folate deficiency, leukaemia, congenital conditions, drugs or concurrent autoimmune disease may cause thrombocytopaenia. Platelet counts during pregnancy should be based on clinical indications.
背景、材料与方法：本文基于对PubMed的检索以及临床经验，对妊娠期血小板减少症进行简要综述。
妊娠期正常血小板计数为250 - 290×10⁹/L，妊娠期血小板减少症可定义为血小板计数低于150×10⁹/L。良性妊娠性血小板减少症（血小板计数70 - 150×10⁹/L，无临床表现或任何母婴风险）在所有妊娠晚期妊娠中发生率为5% - 12%。免疫性血小板减少症（ITP）在每1000例妊娠中约有1 - 2例发生，且可能并发胎儿同种免疫性血小板减少症。近一半的子痫前期病例存在血小板减少症。HELLP综合征（溶血、肝酶升高和血小板计数降低）根据血小板计数进行分类。血栓性血小板减少性紫癜（TTP）、溶血性尿毒症综合征（HUS）和脂肪肝可能意味着血小板计数降低。感染、叶酸缺乏、白血病、先天性疾病、药物或并发自身免疫性疾病可能导致血小板减少症。妊娠期血小板计数应基于临床指征。
