Murray J M, Harris R E
Am J Obstet Gynecol. 1976 Oct 15;126(4):449-51. doi: 10.1016/0002-9378(76)90637-2.
The approach to management of idiopathic thrombocytopenic purpura (ITP) during pregnancy remains controversial--particularly regarding the method of delivery. Regardless of the maternal platelet count, we believe that these patients should be delivered by elective cesarean section at term because of the continued presence of maternal antiplatelet IgG antibodies, which cross the placenta. Despite the method of treatment used to increase maternal platelets, immunologic factors are significnat for neonatal involvement and should be considered in the management of these patients. The single largest factor responsible for reported neonatal losses has been intracranial hemorrhage secondary to thrombocytopenia and birth injury. Two patients with ITP are presented with data to substantiate our position on the method of delivery. The infants were transiently thrombocytopenic following delivery (despite adequate maternal levels of platelets).
妊娠期特发性血小板减少性紫癜（ITP）的管理方法仍存在争议，尤其是在分娩方式方面。无论产妇血小板计数如何，我们认为这些患者应在足月时行择期剖宫产，因为产妇抗血小板IgG抗体持续存在，可穿过胎盘。尽管采用了增加产妇血小板的治疗方法，但免疫因素对新生儿受累具有重要意义，在这些患者的管理中应予以考虑。报告的新生儿死亡的最大单一因素是血小板减少和产伤继发的颅内出血。现介绍两名ITP患者的数据，以证实我们对分娩方式的立场。婴儿在出生后出现短暂性血小板减少（尽管产妇血小板水平充足）。
