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《实践公告第166号:妊娠期血小板减少症》

Practice Bulletin No. 166: Thrombocytopenia in Pregnancy.

出版信息

Obstet Gynecol. 2016 Sep;128(3):e43-53. doi: 10.1097/AOG.0000000000001641.

Abstract

Thrombocytopenia in pregnant women is diagnosed frequently by obstetricians because platelet counts are included with automated complete blood cell counts (CBCs) obtained during routine prenatal screening (). Although most U.S. health care providers are trained using U.S. Conventional Units, most scientists, journals, and countries use Système International (SI) units. The laboratory results reported in U.S. Conventional Units can be converted to SI Units or vice versa by using a conversion factor. The conversion factor for platelet count results is 1.0 (ie, to convert from x 103/µL, multiply by 1.0, to get x 109/L). Thrombocytopenia, defined as a platelet count of less than 150 x 109/L, is common and occurs in 7-12% of pregnancies (). Thrombocytopenia can result from a variety of physiologic or pathologic conditions, several of which are unique to pregnancy. Some causes of thrombocytopenia are serious medical disorders that have the potential for maternal and fetal morbidity. In contrast, other conditions, such as gestational thrombocytopenia, are benign and pose no maternal or fetal risks. Because of the increased recognition of maternal and fetal thrombocytopenia, there are numerous controversies about obstetric management of this condition. Clinicians must weigh the risks of maternal and fetal bleeding complications against the costs and morbidity of diagnostic tests and invasive interventions.

摘要

孕妇血小板减少症常由产科医生诊断,因为在常规产前筛查时获得的自动全血细胞计数(CBC)中包含血小板计数。尽管大多数美国医疗保健提供者接受的是使用美国传统单位的培训,但大多数科学家、期刊和国家使用国际单位制(SI)单位。美国传统单位报告的实验室结果可以通过使用换算因子转换为SI单位,反之亦然。血小板计数结果的换算因子为1.0(即,要从x 10³/µL转换,乘以1.0,得到x 10⁹/L)。血小板减少症定义为血小板计数低于150 x 10⁹/L,很常见,在7%至12%的妊娠中发生。血小板减少症可由多种生理或病理状况引起,其中一些是妊娠特有的。血小板减少症的一些原因是严重的医学疾病,有可能导致母婴发病。相比之下,其他情况,如妊娠期血小板减少症,是良性的,对母婴均无风险。由于对母婴血小板减少症的认识增加,关于这种情况的产科管理存在许多争议。临床医生必须权衡母婴出血并发症的风险与诊断测试和侵入性干预的成本及发病率。

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