免疫性血小板减少性紫癜与经皮脐血采样：一个悬而未决的问题。

Immune thrombocytopenic purpura and percutaneous umbilical blood sampling: an open question.

作者信息

De Carolis S, Noia G, De Santis M, Trivellini C, Mastromarino C, De Carolis M P, Ferrazzani S, Caruso A

机构信息

Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.

出版信息

Fetal Diagn Ther. 1993 May-Jun;8(3):154-60. doi: 10.1159/000263815.

DOI:10.1159/000263815

PMID:8240685

Abstract

We performed a retrospective study of 26 pregnancies with chronic immune thrombocytopenic purpura (ITP) or incidental ITP. Thirteen pregnancies were followed without the use of percutaneous umbilical blood sampling (PUBS) and 13 were followed sampling PUBS at 36-40 weeks of gestation. The overall prevalence of neonatal thrombocytopenia was 27%: 50% in chronic ITP, 12.5% in incidental ITP. Symptomatic thrombocytopenia occurred only in infants born to mothers with chronic ITP. Without the use of PUBS, 2 symptomatic thrombocytopenic fetuses were vaginally delivered and there was a high rate of cesarean sections in normal fetuses. Owing to PUBS, a decrease of the cesarean section rate in normal fetuses was observed, but one fetal bradycardia (due to the technique) was encountered. PUBS resulted helpful to indicate the best route of delivery and reducing unnecessary cesarean sections in women with chronic ITP, but in presence of incidental ITP the use of PUBS remains an open question.

摘要

我们对26例患有慢性免疫性血小板减少性紫癜（ITP）或偶发性ITP的妊娠进行了一项回顾性研究。13例妊娠未采用经皮脐血采样（PUBS）进行随访，13例在妊娠36 - 40周时采用PUBS进行随访。新生儿血小板减少症的总体患病率为27%：慢性ITP中为50%，偶发性ITP中为12.5%。有症状的血小板减少症仅发生在患有慢性ITP母亲所生的婴儿中。未采用PUBS时，2例有症状血小板减少症的胎儿经阴道分娩，正常胎儿的剖宫产率较高。由于采用了PUBS，观察到正常胎儿的剖宫产率有所下降，但出现了1例胎儿心动过缓（由于该技术）。PUBS有助于确定最佳分娩途径并减少慢性ITP女性不必要的剖宫产，但对于偶发性ITP，PUBS的使用仍是一个有待解决的问题。