Rokx C, Swart R M, van Houten A A, Leys M B, Duvekot J J, Te Boekhorst P A W
Erasmus Medisch Centrum, Rotterdam.
Ned Tijdschr Geneeskd. 2013;157(33):A6445.
Thrombocytopenia during pregnancy can be caused by a broad variety of disorders. An early diagnosis is essential for timely and adequate therapy. In cases of severe thrombocytopenia, a multidisciplinary approach by a team of obstetricians, haematologists and anaesthesiologists is needed. We describe a 30-year-old patient at a gestational age of 35 weeks who presented with preterm rupture of membranes. Coincidentally, she also had severe thrombocytopenia that proved to be due to immune thrombocytopenia (ITP). The severe thrombocytopenia persisted despite standard first-line treatment with corticosteroids and intravenous immunoglobulins. Based on this case report we discuss the differential diagnosis of thrombocytopenia during pregnancy with a focus on the management of ITP in pregnant women.
孕期血小板减少可由多种疾病引起。早期诊断对于及时且充分的治疗至关重要。对于严重血小板减少的病例,需要产科医生、血液科医生和麻醉科医生组成的多学科团队进行处理。我们描述了一名30岁、孕35周的患者,该患者出现胎膜早破。巧合的是,她还患有严重血小板减少症,经证实是由免疫性血小板减少症(ITP)所致。尽管采用了皮质类固醇和静脉注射免疫球蛋白的标准一线治疗,但严重血小板减少症仍持续存在。基于本病例报告,我们讨论孕期血小板减少的鉴别诊断,重点是孕妇ITP的管理。