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Thrombositopenia in Pregnancy

Year 2014, Volume: 3 Issue: 1, 99 - 104, 01.01.2014

Şafak Şahin Umut Bingöl Asker Zeki Özsoy Türker Taşlıyurt

https://doi.org/10.5505/abantmedj.2014.44265

Abstract

Thrombocytopenia is a common finding in pregnancy. There are very different etiologies for thrombocytopenia, some of which are unique to pregnancy. Thrombocytopenia in pregnant women can be associated with substantial maternal and baby morbidity and mortality. Thrombocytopenia in pregnancy may be generally a diagnostic and management problem In this review, a diagnostic approach to investigating and treatment thrombocytopenia in pregnancy is presented.

Keywords

Thrombositopenia pregnancy

References

  • 1. Chakraverty R, Davidson S, Peggs K, Stross P, Garrard C, Littlewood TJ. The incidence and cause of coagulopathies in an intensive care population. British journal of haematology. 1996;93(2):460-3.
  • 2. Matthews JH, Benjamin S, Gill DS, Smith NA. Pregnancy-associated thrombocytopenia: definition, incidence and natural history. Acta haematologica. 1990;84(1):24-9.
  • 3. Sainio S, Kekomaki R, Riikonen S, Teramo K. Maternal thrombocytopenia at term: a populationbased study. Acta obstetricia et gynecologica Scandinavica. 2000;79(9):744-9.
  • 4. Verdy E, Bessous V, Dreyfus M, Kaplan C, Tchernia G, Uzan S. Longitudinal analysis of platelet count and volume in normal pregnancy. Thrombosis and haemostasis. 1997;77(4):806-7.
  • 5. Burrows RF, Kelton JG. Thrombocytopenia at delivery: a prospective survey of 6715 deliveries. American journal of obstetrics and gynecology. 1990;162(3):731-4.
  • 6. Shehata N, Burrows R, Kelton JG. Gestational thrombocytopenia. Clinical obstetrics and gynecology. 1999;42(2):327-34.
  • 7. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstetrics and gynecology. 2009;114(6):1326-31.
  • 8. Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Obstetrics and gynecology. 2000;95(1):29-33.
  • 9. Tsunoda T, Ohkuchi A, Izumi A, Watanabe T, Matsubara S, Sato I, et al. Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies. Acta obstetricia et gynecologica Scandinavica. 2002;81(9):840-5.
  • 10. Win N, Rowley M, Pollard C, Beard J, Hambley H, Booker M. Severe gestational (incidental) thrombocytopenia: to treat or not to treat. Hematology. 2005;10(1):69-72.
  • 11. Lescale KB, Eddleman KA, Cines DB, Samuels P, Lesser ML, McFarland JG, et al. Antiplatelet antibody testing in thrombocytopenic pregnant women. American journal of obstetrics and gynecology. 1996;174(3):1014-8.
  • 12. Ajzenberg N, Dreyfus M, Kaplan C, Yvart J, Weill B, Tchernia G. Pregnancy-associated thrombocytopenia revisited: assessment and follow-up of 50 cases. Blood. 1998;92(12):4573-80.
  • 13. Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. British journal of haematology. 2012;158(1):3-15.
  • 14. Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. The New England journal of medicine. 1993;329(20):1463-6.
  • 15. Silver RM, Branch DW, Scott JR. Maternal thrombocytopenia in pregnancy: time for a reassessment. American journal of obstetrics and gynecology. 1995;173(2):479-82. Epub 1995/08/01.
  • 16. Usha Perepu LR. Maternal thrombocytopenia in pregnancy. Proceedings in Obstetrics and Gynecology. 2013;3(1):6.
  • 17. Cines DB, Blanchette VS. Immune thrombocytopenic purpura. The New England journal of medicine. 2002;346(13):995-1008.
  • 18. Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Seminars in hematology. 2000;37(3):275-89.
  • 19. Martin JN, Jr., Morrison JC, Files JC. Autoimmune thrombocytopenic purpura: current concepts and recommended practices. American journal of obstetrics and gynecology. 1984;150(1):86-96.
  • 20. Sullivan CA, Martin JN, Jr. Management of the obstetric patient with thrombocytopenia. Clinical obstetrics and gynecology. 1995;38(3):521-34.
  • 21. C C. Thromboembolism and thrombophilia in pregnancy. Curr Obstet Gynaecol. 2006;16:321-6.
  • 22. Payne SD, Resnik R, Moore TR, Hedriana HL, Kelly TF. Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia. American journal of obstetrics and gynecology. 1997;177(1):149-55.
  • 23. Letsky EA, Greaves M. Guidelines on the investigation and management of thrombocytopenia in pregnancy and neonatal alloimmune thrombocytopenia. Maternal and Neonatal Haemostasis Working Party of the Haemostasis and Thrombosis Task Force of the British Society for Haematology. British journal of haematology. 1996;95(1):21-6.
  • 24. Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-86.
  • 25. Moise KJ, Jr. Autoimmune thrombocytopenic purpura in pregnancy. Clinical obstetrics and gynecology. 1991;34(1):51-63.
  • 26. Koyama S, Tomimatsu T, Kanagawa T, Kumasawa K, Tsutsui T, Kimura T. Reliable predictors of neonatal immune thrombocytopenia in pregnant women with idiopathic thrombocytopenic purpura. American journal of hematology. 2012;87(1):15-21.
  • 27. Klink DT, van Elburg RM, Schreurs MW, van Well GT. Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development. Clinical & developmental immunology. 2008;2008:271363.
  • 28. Kolp R BK. Hae matological diseases of pregnancy. Lambrou NC.Morse AN.Wallach E. The John Hopkins Manuel And Gynecology and Obstetrics. Philedelphia,Lipincott Willams and Wilkins Company. 1999:138 -9.
  • 29. Ruggenenti P, Noris M, Remuzzi G. Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Kidney international. 2001;60(3):831-46.
  • 30. Peyvandi F, Palla R, Lotta LA, Mackie I, Scully MA, Machin SJ. ADAMTS-13 assays in thrombotic thrombocytopenic purpura. Journal of thrombosis and haemostasis : JTH. 2010;8(4):631-40.
  • 31. McMinn JR, George JN. Evaluation of women with clinically suspected thrombotic thrombocytopenic purpura-hemolytic uremic syndrome during pregnancy. Journal of clinical apheresis. 2001;16(4):202-9.
  • 32. George JN. The thrombotic thrombocytopenic purpura and hemolytic uremic syndromes: evaluation, management, and long-term outcomes experience of the Oklahoma TTP-HUS Registry, 1989-2007. Kidney international Supplement. 2009(112):S52-4.
  • 33. Ilter E, Haliloglu B, Temelli F, Ozden S. Thrombotic thrombocytopenic purpura and pregnancy treated with fresh-frozen plasma infusions after plasmapheresis: a case report. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2007;18(7):689-90.
  • 34. Wallis AB, Saftlas AF, Hsia J, Atrash HK. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987-2004. American journal of hypertension. 2008;21(5):521- 6.
  • 35. American College of Obstet Gynecol 202 ACOG Practice bulletin: diagnosis and management of preeclamsia in pregnancy. . Obstetrics and gynecology. 1999:159-67.
  • 36. Burrows RF, Hunter DJ, Andrew M, Kelton JG. A prospective study investigating the mechanism of thrombocytopenia in preeclampsia. Obstetrics and gynecology. 1987;70(3 Pt 1):334-8.
  • 37. Nilsson E, Salonen Ros H, Cnattingius S, Lichtenstein P. The importance of genetic and environmental effects for pre-eclampsia and gestational hypertension: a family study. BJOG : an international journal of obstetrics and gynaecology. 2004;111(3):200-6.
  • 38. Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clinics in perinatology. 2004;31(4):807-33.
  • 39. Stone JH. HELLP syndrome: hemolysis, elevated liver enzymes, and low platelets. JAMA : the journal of the American Medical Association. 1998;280(6):559-62.
  • 40. Thachil J, Toh CH. Disseminated intravascular coagulation in obstetric disorders and its acute haematological management. Blood reviews. 2009;23(4):167-76.

Gebelikte Trombositopeni

Year 2014, Volume: 3 Issue: 1, 99 - 104, 01.01.2014

Şafak Şahin Umut Bingöl Asker Zeki Özsoy Türker Taşlıyurt

https://doi.org/10.5505/abantmedj.2014.44265

Abstract

Trombositopeni gebelikte yaygın bir bulgudur. Trombositopenin bazıları gebelikle ilişkili olan çok farklı nedenleri vardır. Gebelikte trombositopeni, anne veya bebek morbidite ve mortalitesi ile ilişkili olabilir. Gebelikte trombositopeninin tanı ve tedavisi genellikle problem oluşturmaktadır. Bu derlemede, gebelikte trombositopeni için bir tanısal yaklaşım ve tedavi ortaya konulmuştur.

Keywords

Trombositopeni Gebelik

References

  • 1. Chakraverty R, Davidson S, Peggs K, Stross P, Garrard C, Littlewood TJ. The incidence and cause of coagulopathies in an intensive care population. British journal of haematology. 1996;93(2):460-3.
  • 2. Matthews JH, Benjamin S, Gill DS, Smith NA. Pregnancy-associated thrombocytopenia: definition, incidence and natural history. Acta haematologica. 1990;84(1):24-9.
  • 3. Sainio S, Kekomaki R, Riikonen S, Teramo K. Maternal thrombocytopenia at term: a populationbased study. Acta obstetricia et gynecologica Scandinavica. 2000;79(9):744-9.
  • 4. Verdy E, Bessous V, Dreyfus M, Kaplan C, Tchernia G, Uzan S. Longitudinal analysis of platelet count and volume in normal pregnancy. Thrombosis and haemostasis. 1997;77(4):806-7.
  • 5. Burrows RF, Kelton JG. Thrombocytopenia at delivery: a prospective survey of 6715 deliveries. American journal of obstetrics and gynecology. 1990;162(3):731-4.
  • 6. Shehata N, Burrows R, Kelton JG. Gestational thrombocytopenia. Clinical obstetrics and gynecology. 1999;42(2):327-34.
  • 7. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstetrics and gynecology. 2009;114(6):1326-31.
  • 8. Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Obstetrics and gynecology. 2000;95(1):29-33.
  • 9. Tsunoda T, Ohkuchi A, Izumi A, Watanabe T, Matsubara S, Sato I, et al. Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies. Acta obstetricia et gynecologica Scandinavica. 2002;81(9):840-5.
  • 10. Win N, Rowley M, Pollard C, Beard J, Hambley H, Booker M. Severe gestational (incidental) thrombocytopenia: to treat or not to treat. Hematology. 2005;10(1):69-72.
  • 11. Lescale KB, Eddleman KA, Cines DB, Samuels P, Lesser ML, McFarland JG, et al. Antiplatelet antibody testing in thrombocytopenic pregnant women. American journal of obstetrics and gynecology. 1996;174(3):1014-8.
  • 12. Ajzenberg N, Dreyfus M, Kaplan C, Yvart J, Weill B, Tchernia G. Pregnancy-associated thrombocytopenia revisited: assessment and follow-up of 50 cases. Blood. 1998;92(12):4573-80.
  • 13. Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. British journal of haematology. 2012;158(1):3-15.
  • 14. Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. The New England journal of medicine. 1993;329(20):1463-6.
  • 15. Silver RM, Branch DW, Scott JR. Maternal thrombocytopenia in pregnancy: time for a reassessment. American journal of obstetrics and gynecology. 1995;173(2):479-82. Epub 1995/08/01.
  • 16. Usha Perepu LR. Maternal thrombocytopenia in pregnancy. Proceedings in Obstetrics and Gynecology. 2013;3(1):6.
  • 17. Cines DB, Blanchette VS. Immune thrombocytopenic purpura. The New England journal of medicine. 2002;346(13):995-1008.
  • 18. Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Seminars in hematology. 2000;37(3):275-89.
  • 19. Martin JN, Jr., Morrison JC, Files JC. Autoimmune thrombocytopenic purpura: current concepts and recommended practices. American journal of obstetrics and gynecology. 1984;150(1):86-96.
  • 20. Sullivan CA, Martin JN, Jr. Management of the obstetric patient with thrombocytopenia. Clinical obstetrics and gynecology. 1995;38(3):521-34.
  • 21. C C. Thromboembolism and thrombophilia in pregnancy. Curr Obstet Gynaecol. 2006;16:321-6.
  • 22. Payne SD, Resnik R, Moore TR, Hedriana HL, Kelly TF. Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia. American journal of obstetrics and gynecology. 1997;177(1):149-55.
  • 23. Letsky EA, Greaves M. Guidelines on the investigation and management of thrombocytopenia in pregnancy and neonatal alloimmune thrombocytopenia. Maternal and Neonatal Haemostasis Working Party of the Haemostasis and Thrombosis Task Force of the British Society for Haematology. British journal of haematology. 1996;95(1):21-6.
  • 24. Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-86.
  • 25. Moise KJ, Jr. Autoimmune thrombocytopenic purpura in pregnancy. Clinical obstetrics and gynecology. 1991;34(1):51-63.
  • 26. Koyama S, Tomimatsu T, Kanagawa T, Kumasawa K, Tsutsui T, Kimura T. Reliable predictors of neonatal immune thrombocytopenia in pregnant women with idiopathic thrombocytopenic purpura. American journal of hematology. 2012;87(1):15-21.
  • 27. Klink DT, van Elburg RM, Schreurs MW, van Well GT. Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development. Clinical & developmental immunology. 2008;2008:271363.
  • 28. Kolp R BK. Hae matological diseases of pregnancy. Lambrou NC.Morse AN.Wallach E. The John Hopkins Manuel And Gynecology and Obstetrics. Philedelphia,Lipincott Willams and Wilkins Company. 1999:138 -9.
  • 29. Ruggenenti P, Noris M, Remuzzi G. Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Kidney international. 2001;60(3):831-46.
  • 30. Peyvandi F, Palla R, Lotta LA, Mackie I, Scully MA, Machin SJ. ADAMTS-13 assays in thrombotic thrombocytopenic purpura. Journal of thrombosis and haemostasis : JTH. 2010;8(4):631-40.
  • 31. McMinn JR, George JN. Evaluation of women with clinically suspected thrombotic thrombocytopenic purpura-hemolytic uremic syndrome during pregnancy. Journal of clinical apheresis. 2001;16(4):202-9.
  • 32. George JN. The thrombotic thrombocytopenic purpura and hemolytic uremic syndromes: evaluation, management, and long-term outcomes experience of the Oklahoma TTP-HUS Registry, 1989-2007. Kidney international Supplement. 2009(112):S52-4.
  • 33. Ilter E, Haliloglu B, Temelli F, Ozden S. Thrombotic thrombocytopenic purpura and pregnancy treated with fresh-frozen plasma infusions after plasmapheresis: a case report. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2007;18(7):689-90.
  • 34. Wallis AB, Saftlas AF, Hsia J, Atrash HK. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987-2004. American journal of hypertension. 2008;21(5):521- 6.
  • 35. American College of Obstet Gynecol 202 ACOG Practice bulletin: diagnosis and management of preeclamsia in pregnancy. . Obstetrics and gynecology. 1999:159-67.
  • 36. Burrows RF, Hunter DJ, Andrew M, Kelton JG. A prospective study investigating the mechanism of thrombocytopenia in preeclampsia. Obstetrics and gynecology. 1987;70(3 Pt 1):334-8.
  • 37. Nilsson E, Salonen Ros H, Cnattingius S, Lichtenstein P. The importance of genetic and environmental effects for pre-eclampsia and gestational hypertension: a family study. BJOG : an international journal of obstetrics and gynaecology. 2004;111(3):200-6.
  • 38. Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clinics in perinatology. 2004;31(4):807-33.
  • 39. Stone JH. HELLP syndrome: hemolysis, elevated liver enzymes, and low platelets. JAMA : the journal of the American Medical Association. 1998;280(6):559-62.
  • 40. Thachil J, Toh CH. Disseminated intravascular coagulation in obstetric disorders and its acute haematological management. Blood reviews. 2009;23(4):167-76.
There are 40 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Şafak Şahin This is me

Umut Bingöl This is me

Asker Zeki Özsoy This is me

Türker Taşlıyurt This is me

Publication Date January 1, 2014
Published in Issue Year 2014 Volume: 3 Issue: 1

Cite

APA Şahin, Ş., Bingöl, U., Özsoy, A. Z., Taşlıyurt, T. (2014). Gebelikte Trombositopeni. Abant Medical Journal, 3(1), 99-104. https://doi.org/10.5505/abantmedj.2014.44265
AMA Şahin Ş, Bingöl U, Özsoy AZ, Taşlıyurt T. Gebelikte Trombositopeni. Abant Med J. January 2014;3(1):99-104. doi:10.5505/abantmedj.2014.44265
Chicago Şahin, Şafak, Umut Bingöl, Asker Zeki Özsoy, and Türker Taşlıyurt. “Gebelikte Trombositopeni”. Abant Medical Journal 3, no. 1 (January 2014): 99-104. https://doi.org/10.5505/abantmedj.2014.44265.
EndNote Şahin Ş, Bingöl U, Özsoy AZ, Taşlıyurt T (January 1, 2014) Gebelikte Trombositopeni. Abant Medical Journal 3 1 99–104.
IEEE Ş. Şahin, U. Bingöl, A. Z. Özsoy, and T. Taşlıyurt, “Gebelikte Trombositopeni”, Abant Med J, vol. 3, no. 1, pp. 99–104, 2014, doi: 10.5505/abantmedj.2014.44265.
ISNAD Şahin, Şafak et al. “Gebelikte Trombositopeni”. Abant Medical Journal 3/1 (January 2014), 99-104. https://doi.org/10.5505/abantmedj.2014.44265.
JAMA Şahin Ş, Bingöl U, Özsoy AZ, Taşlıyurt T. Gebelikte Trombositopeni. Abant Med J. 2014;3:99–104.
MLA Şahin, Şafak et al. “Gebelikte Trombositopeni”. Abant Medical Journal, vol. 3, no. 1, 2014, pp. 99-104, doi:10.5505/abantmedj.2014.44265.
Vancouver Şahin Ş, Bingöl U, Özsoy AZ, Taşlıyurt T. Gebelikte Trombositopeni. Abant Med J. 2014;3(1):99-104.