Gasim Turki
Department of Obstetrics and Gynecology, College of Medicine, Dammam University and King Fahad University Hospital, Al Khobar, Saudi Arabia.
J Reprod Med. 2011 Mar-Apr;56(3-4):163-8.
To evaluate the complications of pregnancy and perinatal outcome in women with idiopathic thrombocytopenic purpura (ITP).
A retrospective analysis of 38 singleton pregnancies, their course, obstetric management and perinatal outcome of 32 patients with known ITP was undertaken.
No major antenatal complications were noted among the patients. There were no maternal deaths, and only 1 stillbirth occurred in the series. Fourteen infants were delivered by cesarean section and 24 by vaginal delivery. Neonatal cord blood platelet count was performed in each of the live-born infants and revealed thrombocytopenia in 16 infants, but in only 6 (16.2%) of them was the cord blood platelet count < 50 x 10(9)/L. There was no neonatal death in the study, although 6 infants required supportive treatment with corticosteroids and intravenous immunoglobulin G. No maternal features could be used to predict the neonatal platelet count at birth. These results are comparable with other studies in the recent literature.
Due to the low incidence of poor neonatal outcome in mothers with ITP, obstetric intervention based solely on their platelet count is not justified. Every patient with ITP should be managed individually, and the routine use of cesarean section should be abandoned.
评估特发性血小板减少性紫癜（ITP）女性患者的妊娠并发症及围产期结局。
对32例已知患有ITP的患者的38次单胎妊娠、其病程、产科处理及围产期结局进行回顾性分析。
患者中未发现重大产前并发症。该系列中无孕产妇死亡，仅发生1例死产。14例婴儿通过剖宫产分娩，24例通过阴道分娩。对每例活产婴儿进行了新生儿脐血血小板计数，结果显示16例婴儿存在血小板减少，但其中只有6例（16.2%）脐血血小板计数<50×10⁹/L。研究中无新生儿死亡，尽管有6例婴儿需要使用皮质类固醇和静脉注射免疫球蛋白G进行支持治疗。没有母体特征可用于预测出生时的新生儿血小板计数。这些结果与近期文献中的其他研究结果相当。
由于ITP母亲的新生儿不良结局发生率较低，仅基于其血小板计数进行产科干预是不合理的。每例ITP患者都应进行个体化管理，应摒弃常规剖宫产的做法。
