Neuhart D, Dreyfus M, Baldauf J J, Maloisel F, Ritter J
Service de Gynécologie-Obstétrique 1, Hôpital de Hautepierre, Strasbourg.
J Gynecol Obstet Biol Reprod (Paris). 1996;25(2):206-11.
Fetal and neonatal immune thrombocytopenias with platelet count less than 150.10(9)/l, result from transplacental passage of maternal platelet-specific antibodies. The main risk of these diseases is severe brain damage or death due to intracranial hemorrhage. Prevention and screening are difficult because of the lack of predicting factors. Only some women are at high risk of fetal thrombocytopenia (HLA DRW 52a HPA-la negative women or women with a previous history of immune thrombocytopenic purpura and having platelet-specific autoantibodies). Antenatal diagnosis and therapy have altered the natural course of fetal alloimmune thrombocytopenia. No prenatal treatment has proved to be effective in autoimmune thrombocytopenia and prenatal diagnosis by fetal blood sampling is controversial. A better knowledge of the pathogenesis of gestational incidental thrombocytopenia in otherwise healthy pregnancies, could define a group at high risk of fetal thrombocytopenia.
血小板计数低于150×10⁹/L的胎儿和新生儿免疫性血小板减少症，是由母体血小板特异性抗体经胎盘传递所致。这些疾病的主要风险是因颅内出血导致严重脑损伤或死亡。由于缺乏预测因素，预防和筛查较为困难。只有部分女性有胎儿血小板减少的高风险（HLA DRW 52a HPA-1a阴性女性或有免疫性血小板减少性紫癜病史且有血小板特异性自身抗体的女性）。产前诊断和治疗改变了胎儿同种免疫性血小板减少症的自然病程。尚无证据表明产前治疗对自身免疫性血小板减少症有效，且通过胎儿血样采集进行产前诊断存在争议。更好地了解健康妊娠中妊娠期偶发性血小板减少症的发病机制，可能会确定一组胎儿血小板减少的高风险人群。
