Gestasyonel Trombositopeninin Maternal ve Fetal Sonuçları

Year 2022, Volume: 24 Issue: 3, 282 - 286, 30.12.2022

Bahar Taş Oğuzhan Günenc

https://doi.org/10.18678/dtfd.1162645

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı gestasyonel trombositopeninin maternal ve fetal sonuçlarının trombosit seviyelerine göre değerlendirilmesidir.
Gereç ve Yöntemler: Ocak 2017 ve Aralık 2018 tarihleri arasında kliniğimizde takip edilen, ek bir hastalığı olmayan, miad doğum yapmış olan ve gestasyonel trombositopeni saptanmış olan olgular geriye dönük olarak tarandı. Çalışmaya dahil edilen gebeler trombosit değerlerine göre ≤70 x103/mm3 ve >70 x103/mm3 şeklinde iki alt gruba ayrıldı ve bu alt gruplar kendi arasında analiz edildi. Ayrıca, hastaların demografik, klinik ve laboratuvar verileri de gruplar arasında karşılaştırıldı.
Bulgular: Gestasyonel trombositopeni tanısı olan hastalardan; trombosit değeri ≤70 x103/mm3 olan grupta doğum haftasının anlamlı olarak daha erken olduğu görüldü (p=0,002). Gruplar arasında perinatal özellikler karşılaştırıldığında ise, trombosit değeri ≤70 x103/mm3 olan gruptaki bebeklerin doğum ağırlıklarının diğer grupta olanlara göre anlamlı şekilde daha düşük olduğu bulundu (p=0,033). APGAR 1. dakika skoru trombosit değeri ≤70 x103/mm3 olan grupta diğer grup ile karşılaştırıldığında anlamlı şekilde azalmış olarak bulundu (p=0,039). Gestasyonel trombositopenisi olan gebelerde tekli ve çoklu regresyon analizi yapıldı. Trombosit değerleri ≤70 x103/mm3 olan grupta olumsuz maternal ve perinatal sonuçlar ile ilişkili olan bir risk faktörü saptanmadı.
Sonuç: Gestasyonel trombositopeni tanısı alan ve trombosit değerleri 70 x103/mm3 altında olan hastalarda fetal gelişme geriliği görülmekte ve APGAR skorları daha düşük olmaktadır. Aynı hasta grubunda erken doğum oranı daha yüksektir.

Keywords

Gestasyonel Trombositopeni, Gebelik, Maternal Sonuçlar, Fetal Sonuçlar

Maternal and Fetal Outcomes of Gestational Thrombocytopenia

Abstract

Aim: The study aimed to evaluate maternal and fetal outcomes of gestational thrombocytopenia according to platelet levels.
Material and Methods: The cases who were followed up in our clinic between January 2017 and December 2018, who had no additional diseases, who had term deliveries, and who had gestational thrombocytopenia, were screened retrospectively. The pregnant women included in the study were divided into two groups according to their platelet values, ≤70 x103/mm3 and >70 x103/mm3, and the subgroups were analyzed among themselves. The demographic, clinical, and laboratory data of the patients were also compared between the groups.
Results: Among the patients with gestational thrombocytopenia, it was found that the birth week was significantly earlier in the group with platelet ≤70 x103/mm3 (p=0.002). When perinatal characteristics were compared between the groups, the birth weight of the infants in the group with platelet ≤70 x103/mm3 was found to be significantly lower than in the other group (p=0.033). APGAR 1st-minute score was found to be significantly decreased in the group with platelet ≤70 x103/mm3 when compared to the other group (p=0.039). Single and multiple regression analyzes were performed on pregnant women with gestational thrombocytopenia. No risk factors that were associated with adverse maternal and perinatal outcomes were detected in the group with platelet values ≤70 x103/mm3.
Conclusion: Fetal growth retardation is seen in patients diagnosed with gestational thrombocytopenia and with platelet values below 70 x103/mm3 and their APGAR scores are lower. The premature birth rate is higher in the same patient group.

Keywords

Gestational Thrombositopenia, pregnancy, Maternal Outcomes, Fetal Outcomes

References

• Gernsheimer TB. Thrombocytopenia in pregnancy: is this immune thrombocytopenia or...? Hematology Am Soc Hematol Educ Program. 2012;2012:198-202.
• McCrae KR. Thrombocytopenia in pregnancy. Hematology Am Soc Hematol Educ Program. 2010;2010:397-402.
• McCrae KR. Thrombocytopenia in pregnancy: differential diagnosis, pathogenesis, and management. Blood Rev. 2003;17(1):7-14.
• Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. Br J Haematol. 2012;158(1):3-15.
• Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol. 2000;95(1):29-33.
• Sainio S, Kekomäki R, Riikonen S, Teramo K. Maternal thrombocytopenia at term: a population-based study. Acta Obstet Gynecol Scand. 2000;79(9):744-9.
• Kasai J, Aoki S, Kamiya N, Hasegawa Y, Kurasawa K, Takahashi T, et al. Clinical features of gestational thrombocytopenia difficult to differentiate from immune thrombocytopenia diagnosed during pregnancy. J Obstet Gynaecol Res. 2015;41(1):44-9.
• Shehata N, Burrows R, Kelton JG. Gestational thrombocytopenia. Clin Obstet Gynecol. 1999;42(2):327-34.
• Parnas M, Sheiner E, Shoham-Vardi I, Burstein E, Yermiahu T, Levi I, et al. Moderate to severe thrombocytopenia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2006;128(1-2):163-8.
• Webert KE, Mittal R, Sigouin C, Heddle NM, Kelton JG. A retrospective 11-year analysis of obstetric patients with idiopathic thrombocytopenic purpura. Blood. 2003;102(13):4306-11.
• Say L, Souza JP, Pattinson RC; WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss--towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23(3):287-96.
• who.int [Internet]. World Health Organization. Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health, 2011. [Cited: 2022 July 20]. Available from: https://apps.who.int/iris/handle/10665/44692
• Artunç Ülkümen B, Aktenk F, Baytur Y. Feto-maternal outcomes of pregnancies with thrombocytopenia. J Kartal TR. 2014;25(2):89-94. Turkish.
• Wang X, Xu Y, Luo W, Feng H, Luo Y, Wang Y, et al. Thrombocytopenia in pregnancy with different diagnoses: Differential clinical features, treatments, and outcomes. Medicine (Baltimore). 2017;96(29):e7561.
• Elveđi-Gašparović V, Beljan P, Gverić-Ahmetašević S, Schuster S, Škrablin S. Fetal-maternal complications and their association with gestational thrombocytopenia. Ginekol Pol. 2016;87(6):454-9.