van den Akker Esa, Oepkes D, Brand A, Kanhai H H H
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
BJOG. 2006 Jul;113(7):781-3. doi: 10.1111/j.1471-0528.2006.00993.x.
To evaluate the safety of vaginal delivery in pregnancies with fetal and neonatal alloimmune thrombocytopenia (FNAIT).
Prospective data collection.
Leiden University Medical Centre, the national centre for management of severe red cell and platelet alloimmunisation.
Thirty-two pregnancies with FNAIT, with a sibling with thrombocytopenia but without an intracranial haemorrhage (ICH).
The mode of delivery, platelet count in cord blood and neonatal outcome were analysed. All women received weekly intravenous immunoglobulin from 32 to 38 weeks of gestation. Head ultrasound scan was performed in all neonates.
Signs of ICH or other bleeding in the neonates.
Twenty-three women delivered vaginally. Nine caesarean sections were performed, all for obstetric reasons. Median platelet count at birth was 142 x 10(9)/l (range, 4-252 x 10(9)/l), with severe thrombocytopenia (<50 x10(9)/l) in four neonates, of which three were born vaginally. None of the neonates showed signs of ICH or other bleeding.
In pregnancies with FNAIT and a thrombocytopenic sibling without ICH, vaginal delivery was not associated with neonatal intracranial bleeding. These initial results support our noninvasive management of these pregnancies with FNAIT.
评估胎儿和新生儿同种免疫性血小板减少症（FNAIT）孕妇阴道分娩的安全性。
前瞻性数据收集。
莱顿大学医学中心，国家严重红细胞和血小板同种免疫管理中心。
32例FNAIT孕妇，其同胞有血小板减少症但无颅内出血（ICH）。
分析分娩方式、脐血血小板计数及新生儿结局。所有孕妇在妊娠32至38周期间每周接受静脉注射免疫球蛋白。所有新生儿均进行头部超声检查。
新生儿ICH或其他出血迹象。
23例孕妇经阴道分娩。9例行剖宫产，均因产科原因。出生时血小板计数中位数为142×10⁹/L（范围4 - 252×10⁹/L），4例新生儿有严重血小板减少症（<50×10⁹/L），其中3例经阴道分娩。无新生儿出现ICH或其他出血迹象。
对于有FNAIT且同胞有血小板减少症但无ICH的孕妇，阴道分娩与新生儿颅内出血无关。这些初步结果支持我们对这些FNAIT孕妇的无创管理。
Zotero 插件