Domula M, Weissbach G, Lenk H, Keller J
Zentralbl Gynakol. 1977;99(8):473-81.
Drug therapy in mothers may lead to various disturbances of the hemostasis of the newborn. Some authors reported on severe hemorrhages in newborn after coumarin treatment of the mothers, others had not or only seldom observed such events. Our examination did not reveal any significant clotting disorders in 4 newborns whose mothers had received Athrombom. Perhaps the indandion derivative does not significantly penetrate the placental barrier. However, therapy with anticoagulants of the vitamin K antagonist type may be instituted during pregnancy only in cases where it is strictly indicated. Streptokinase and heparin will certainly not enter the fetal circulation, therefore they may be used without risk for the child. Furthermore the clinican must known severe bleeding conditions of the vitamin K deficiency type in newborns of mothers with anticonvulsive therapy. Preventive administration of vitamin K to pregnant women and newborns or, in the presence of bleedings, instantaneous and exact substitution may bring under control the critical situation. Acetylsalicylic acid given during the last weeks of pregnancy causes an inhibition of the aggregation of thrombocytes of the newborn. Bleedings occur only seldom. Other drugs administered during pregnancy may induce neonatal thrombocytopenia through immunological or toxic mechanisms, such for instance quinine, quinidine, tolbutamide and thiazides.
母亲接受药物治疗可能会导致新生儿止血出现各种紊乱。一些作者报道了母亲接受香豆素治疗后新生儿发生严重出血的情况,而其他作者则未观察到或仅很少观察到此类事件。我们对4名母亲接受了Athrombom治疗的新生儿进行检查,未发现任何明显的凝血障碍。也许茚满二酮衍生物不会显著穿透胎盘屏障。然而,只有在严格指征的情况下,才可在孕期使用维生素K拮抗剂类抗凝剂进行治疗。链激酶和肝素肯定不会进入胎儿循环,因此使用它们对胎儿没有风险。此外,临床医生必须了解接受抗惊厥治疗的母亲所生新生儿中维生素K缺乏型的严重出血情况。对孕妇和新生儿预防性给予维生素K,或在出血时立即进行准确替代,可控制危急情况。在妊娠最后几周给予乙酰水杨酸会抑制新生儿血小板的聚集。出血情况很少发生。孕期使用的其他药物可能通过免疫或毒性机制导致新生儿血小板减少,例如奎宁、奎尼丁、甲苯磺丁脲和噻嗪类药物。