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特发性血小板减少性紫癜患者的妊娠结局

Pregnancy outcome in patients with idiopathic thrombocytopenic purpura.

作者信息

Subbaiah Murali, Kumar Sunesh, Roy Kallol Kumar, Sharma Jai Bhagwan, Singh Neeta

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India,

出版信息

Arch Gynecol Obstet. 2014 Feb;289(2):269-73. doi: 10.1007/s00404-013-2958-x. Epub 2013 Jul 14.

Abstract

OBJECTIVE

To study the outcome of pregnancy in women with idiopathic thrombocytopenic purpura.

MATERIALS AND METHODS

A retrospective analysis of 30 pregnancies in 26 women with idiopathic thrombocytopenic purpura was carried out at a tertiary hospital in India. The courses of the disease, maternal and perinatal outcome in these pregnancies were studied.

RESULTS

Mean age of pregnant women with idiopathic thrombocytopenic purpura was 27.3 years and 61.5 % was primigravidae. Out of 26 patients with idiopathic thrombocytopenic purpura, 16 were already diagnosed while the other 10 were diagnosed during pregnancy. The incidence of bleeding episodes in antenatal period, severe thrombocytopenia and hemorrhagic complications at the time of delivery was 30, 37 and 11.1 %, respectively. Oral steroids were required in 40 % of pregnancies. Two patients received intravenous immunoglobulin therapy. Severe thrombocytopenia at the time of delivery was more commonly seen in women in whom ITP was diagnosed during pregnancy as compared to those in whom ITP was diagnosed prior to pregnancy (P = 0.04). Severe thrombocytopenia was seen in 18.5 % of neonates and intracranial hemorrhage was detected in 1 neonate. There were no still births or maternal mortality.

CONCLUSION

Pregnancy outcome in patients with idiopathic thrombocytopenic purpura is generally good.

摘要

目的

研究特发性血小板减少性紫癜患者的妊娠结局。

材料与方法

在印度一家三级医院对26例特发性血小板减少性紫癜患者的30次妊娠进行回顾性分析。研究这些妊娠中疾病的病程、孕产妇及围产期结局。

结果

特发性血小板减少性紫癜孕妇的平均年龄为27.3岁,初产妇占61.5%。26例特发性血小板减少性紫癜患者中,16例已确诊,另10例在孕期确诊。产前出血事件、分娩时严重血小板减少及出血并发症的发生率分别为30%、37%和11.1%。40%的妊娠需要口服类固醇。2例患者接受了静脉注射免疫球蛋白治疗。与妊娠前确诊特发性血小板减少性紫癜的女性相比,妊娠期间确诊的女性在分娩时更常见严重血小板减少(P = 0.04)。18.5%的新生儿出现严重血小板减少,1例新生儿检测到颅内出血。无死产或孕产妇死亡。

结论

特发性血小板减少性紫癜患者的妊娠结局总体良好。

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