胎儿血小板减少症在胎儿贫血合并红细胞同种免疫引起的妊娠中的作用：队列研究和荟萃分析。

Fetal thrombocytopenia in pregnancies complicated by fetal anemia due to red-cell alloimmunization: cohort study and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Bernard Becker Medical Library, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

出版信息

J Perinatol. 2019 Jul;39(7):920-926. doi: 10.1038/s41372-019-0388-8. Epub 2019 May 9.

DOI:10.1038/s41372-019-0388-8

PMID:31073147

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6592719/

Abstract

OBJECTIVE

To estimate the prevalence and characteristics of fetal thrombocytopenia at the time of percutaneous umbilical cord sampling (PUBS) in pregnancies complicated by alloimmunization and to conduct a systematic review on fetal thrombocytopenia in these pregnancies.

STUDY DESIGN

Retrospective cohort study of all patients undergoing PUBS at our institution from 2000-2017. Clinical data, including fetal platelet counts, were abstracted from the medical record and analyzed with routine statistical procedures. A systematic review and meta-analysis were also conducted according to standard procedures.

RESULT

At first procedure, prior to any transfusion, 13/36 fetuses (36%) had thrombocytopenia: 11/36 (31%) had moderate thrombocytopenia and 2/36 (6%) had severe thrombocytopenia (14 patients had no platelet count at first procedure). The systematic review identified six studies, and the prevalence of fetal thrombocytopenia at the time of PUBS for alloimmunization was 18% (95% confidence interval 11%, 26%).

CONCLUSION

Thrombocytopenia is common and underappreciated in fetuses undergoing PUBS for alloimmunization.

摘要

目的

评估在因同种免疫而进行经皮脐带穿刺术（PUBS）时胎儿血小板减少症的发生率和特征，并对这些妊娠中的胎儿血小板减少症进行系统评价。

研究设计

对本机构 2000 年至 2017 年期间所有接受 PUBS 的患者进行回顾性队列研究。从病历中提取临床数据，包括胎儿血小板计数，并采用常规统计程序进行分析。还按照标准程序进行了系统评价和荟萃分析。

结果

首次操作时，在进行任何输血之前，有 13/36 例胎儿（36%）存在血小板减少症：11/36（31%）例存在中度血小板减少症，2/36（6%）例存在严重血小板减少症（14 例首次操作时无血小板计数）。系统评价确定了六项研究，同种免疫时因经皮脐带穿刺术而导致的胎儿血小板减少症的发生率为 18%（95%置信区间为 11%，26%）。