Gilmore K S, McLintock C
National Women's Health, Auckland City Hospital, New Zealand.
Obstet Med. 2018 Mar;11(1):12-16. doi: 10.1177/1753495X17727408. Epub 2017 Oct 25.
We reviewed outcomes of 52 pregnancies in 45 women with immune thrombocytopenic purpura who delivered at Auckland Hospital with an antenatal platelet count of <100 × 10/L.
Primary outcomes were maternal platelet count at delivery and treatment response. Secondary outcomes included post-partum haemorrhage (PPH).
Most women had thrombocytopenia at delivery. Treatment with prednisone was given in 14 (27%) pregnancies with responses considered safe for delivery in 11 pregnancies (79%). Women in eight pregnancies also received intravenous immunoglobulin; in five pregnancies (63%) a platelet response acceptable for delivery was achieved.Seventeen pregnancies (33%) were complicated by a PPH ≥500 mL. Ten pregnancies (19%) were complicated by a PPH ≥1000 mL. PPH was reported in all women with a platelet count <50 × 10/L at delivery.
There were no antenatal bleeding complications but PPH was common among women with platelet counts <50 × 10/L at the time of birth.
我们回顾了45例免疫性血小板减少性紫癜女性的52次妊娠结局，这些女性在奥克兰医院分娩，产前血小板计数<100×10⁹/L。
主要结局为分娩时的母体血小板计数和治疗反应。次要结局包括产后出血（PPH）。
大多数女性在分娩时存在血小板减少。14例（27%）妊娠接受了泼尼松治疗，其中11例（79%）的治疗反应被认为对分娩安全。8例妊娠的女性还接受了静脉注射免疫球蛋白；5例（63%）妊娠实现了可接受的分娩血小板反应。17例（33%）妊娠并发PPH≥500 mL。10例（19%）妊娠并发PPH≥1000 mL。所有分娩时血小板计数<50×10⁹/L的女性均出现PPH。
产前无出血并发症，但出生时血小板计数<50×10⁹/L的女性中PPH很常见。
