Moutet A, Fromont P, Farcet J P, Rotten D, Bettaieb A, Duédari N, Bierling P
Blood Center, Henri Mondor Hospital, Créteil, France.
Arch Intern Med. 1990 Oct;150(10):2141-5.
Thirty-six women with immune thrombocytopenic purpura were studied during 37 pregnancies, and maternal characteristics with predictive value for the fetal platelet count were determined. Nine neonates were thrombocytopenic, with a platelet count of less than 50 x 10(9)/L in eight. Four of these nine neonates delivered to a subgroup of 31 mothers were studied prospectively; the frequency of thrombocytopenia in neonates of women with immune thrombocytopenic purpura was thus 13%. Only two of these nine neonates presented with hemorrhagic syndromes (two, petechial purpura; one, intracranial bleeding). The frequency of neonatal thrombocytopenia was higher in mothers with deep thrombocytopenia and in those who had not responded to corticosteroid treatment following diagnosis. No prognostic value could be assigned to the other maternal characteristics studied, such as a history of splenectomy, maternal treatment at the time of delivery, or the presence of platelet autoantibodies evaluated either with the platelet immunofluorescence test or the platelet Western blot immunoassay.
对36名患有免疫性血小板减少性紫癜的女性在37次妊娠期间进行了研究，并确定了对胎儿血小板计数具有预测价值的母体特征。9名新生儿血小板减少，其中8名血小板计数低于50×10⁹/L。对这9名新生儿中4名来自31名母亲亚组的新生儿进行了前瞻性研究；因此，免疫性血小板减少性紫癜女性新生儿血小板减少的发生率为13%。这9名新生儿中只有2名出现出血综合征（2名，瘀点性紫癜；1名，颅内出血）。母亲血小板严重减少以及诊断后对皮质类固醇治疗无反应的母亲，其新生儿血小板减少的发生率更高。所研究的其他母体特征，如脾切除术史、分娩时的母体治疗或通过血小板免疫荧光试验或血小板蛋白质印迹免疫测定评估的血小板自身抗体的存在，均无预后价值。
