Morelli E, Gamerre M, Dalivoust P, Leclaire M, Ducassou M J
J Gynecol Obstet Biol Reprod (Paris). 1984;13(2):165-72.
Idiopathic thrombocytopenic purpura occurring in pregnancy has a risk for the fetus of severe thrombocytopenia. The handling of these cases obstetrically is controversial. Our experience and that derived from reading the literature suggests that counting the number of maternal platelets does not reflect on the risk for the fetus and the neonate. On the other hand it does seem that estimating the levels of circulating platelet antibodies in the maternal plasma does give an indication of platelet destruction in the fetus. Corticosteroid treatment improves greatly the number of maternal platelets and is probably good treatment for the fetus in utero. Giving gamma-globulins intravenously to the pregnant woman or to the newborn is an interesting therapeutic measure seeing how it is free of danger. How useful this treatment is in pregnancy has yet to be determined.
妊娠期间发生的特发性血小板减少性紫癜会使胎儿面临严重血小板减少的风险。产科处理这些病例存在争议。我们的经验以及从文献中获得的经验表明,计数母体血小板数量并不能反映胎儿和新生儿的风险。另一方面,估计母体血浆中循环血小板抗体的水平似乎确实能提示胎儿血小板的破坏情况。皮质类固醇治疗可显著提高母体血小板数量,可能对子宫内的胎儿是一种有效的治疗方法。鉴于静脉注射丙种球蛋白对孕妇或新生儿无危险,这是一种有趣的治疗措施。这种治疗在妊娠中的有效性还有待确定。