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特发性血小板减少性紫癜产科患者的回顾性分析:单中心研究。

A retrospective analysis of obstetric patients with idiopathic thrombocytopenic purpura: a single center study.

机构信息

Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.

出版信息

Int J Hematol. 2010 Oct;92(3):463-7. doi: 10.1007/s12185-010-0684-8. Epub 2010 Sep 30.

Abstract

Idiopathic thrombocytopenic purpura (ITP) commonly affects women of childbearing age. We studied the clinical characteristics of pregnant women with ITP to estimate their risks of bleeding. A retrospective chart review was performed for all obstetric patients with ITP who had delivery at our hospital, from 1 March 2000 to 31 March 2008. Twenty women with ITP delivered 24 children in 23 pregnancies. In all, eight women were treated with corticosteroid during their pregnancy period, and there was only one non-responder. There was no correlation between the maternal platelet count and the amount of blood loss at delivery. Two infants were revealed to have had platelet counts lower than 30 × 10⁹/L, and were treated with high-dose IV IgG. One of them also received corticosteroid therapy. There was no relationship between maternal platelet count at delivery and infant platelet count at birth. Overall, no serious bleeding event was seen in either of the mothers or infants. For most women with ITP, pregnancy is uncomplicated, and even those with severe thrombocytopenia during pregnancy have good outcomes when under the strict care of a hematologist and gynecologist.

摘要

特发性血小板减少性紫癜(ITP)常影响育龄期妇女。我们研究了妊娠合并 ITP 患者的临床特征,以评估其出血风险。对 2000 年 3 月 1 日至 2008 年 3 月 31 日期间在我院分娩的所有产科 ITP 患者进行了回顾性图表审查。20 名 ITP 患者共分娩了 24 名婴儿,涉及 23 次妊娠。其中 8 名孕妇在孕期接受了皮质类固醇治疗,仅有 1 名无应答者。母体血小板计数与分娩时出血量之间无相关性。有 2 名婴儿的血小板计数低于 30×10⁹/L,接受了大剂量静脉注射免疫球蛋白治疗。其中 1 名还接受了皮质类固醇治疗。母亲分娩时的血小板计数与婴儿出生时的血小板计数之间无关系。总体而言,母亲和婴儿均未发生严重出血事件。对于大多数 ITP 妇女来说,妊娠是无并发症的,即使是那些在妊娠期间血小板严重减少的妇女,在血液科医生和妇科医生的严格护理下,也有良好的结局。

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