Abstract
Purpose: The iam of this study was retrospectively evaluate maternal platelet count fluctuation during pregnancy and puerperium and its correlation with the newborn’s platelet levels. Method: A group of 36 patients who have been referred to a haematology-clinic for gestational thrombocytopenia (GT) and who delivered at the same hospital during a period of 4 years, from January 2006 to December2009 were included in the study. Mothers and their related foetuses- newborns were evaluated retrospectively for symptoms and/or signs of external and internal haemorrhage throughout pregnancy and early puerperium, even in relationship with mode of delivery (caesarean section versus spontaneous vaginal delivery). Results: All observed cases of GT have an uncomplicated course with no related perinatal and maternal morbidity even in patients with initial platelet count < 75.000/ml independently from the route of delivery. Conclusion: In case of gestational thrombocytopenia a complete normalization of maternal platelet count should be expected during the postpartum period, even if a diagnosis of a concomitant incidental neonatal thrombocytopenia cannot be excluded.No intervention, such as a foetal platelet count or caesarean section, is necessary.
References
- Kam PC, Thompson SA, Liew AC. Review article, thrombocytopenia in the parturient. Anaesthesia. 2004; 59:255–64.
- SullivanCA,MartinJNJr. Management of the obstetric patient with thrombocytopenia. Clin Obstet Gynecol. 1995; 38:521–34.
- Boehlen F, Hohlfeld P, Extermann P et al. Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol. 2000; 95: 29–33.
- Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom KD. Williams obstetrics, 21st edn. McGraw-Hill, Hematological disorders. 2001; 1307–38 [Chapter 49].
- Shehata N, Burrow RF, Kelton JG. Gestational thrombocytopenia. Clin Obstet Gynecol. 1999; 42:327–34.
- Michal Parnas, Eyal Sheiner , Ilana Shoham-Vardi, Eliezer Burstein, Tikva Yermiahu, Itai Levi, Gershon Holcberg, Ronit Yerushalmi. Moderate to severe thrombocytopenia during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006; 128:163–8.
- Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Semin Hematol. 2000; 37: 275–89.
- Burrows RF, Kelton GJ. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med. 1993; 329:1463–6.
- Silver RM, Branch DW, Scott JR. Maternal thrombocytopenia in pregnancy: time for a reassessment. Am J Obstet Gynecol. 1995;173:479–
- Nisha S, Amita D, Uma S, Tripathi AK, Pushplata S. Prevalence and Characterization of Thrombocytopenia in Pregnancy in Indian Women Indian J Hematol Blood Transfus. 2012; 28:77-81.
- Cook RL, Miller RC, Katz VL, Cefalo RC. Immune thrombocytopenic purpura in pregnancy: a reappraisal of management. Obstet Gynecol. 1991; 78: 578–83.
- Burrows RF, Kelton JG. Incidentally detected thrombocytopenia in healthy mothers and their infants. N Engl J Med. 1988; 319:142-5
- V. Kiefel, A. Greinacher. Differenzialdiagnose und Differenzialtherapie der Thrombozytopenie. Internist 2010;51:1397–1410.
- Yazışma Adresi / Address for Correspondence: Dr. Carlo Pafumi İstituto di Patologia Ostetrica e Ginecologica Santa Bambino Hospital Catania Universıty ITALY e mail: pafumi@unict.it geliş tarihi/received :07.08.2012 kabul tarihi/accepted:21.12.2012
Abstract
Amaç: Bu çalışmanın amacı, hamilelik ve lohusalık döneminde ki trombosit sayısında meydana gelen değişimleri retrospektif olarak değerlendirmek ve yeni doğanın trombosit sayısı ile arasındaki ilişkiyi ortaya koymaktır. Materyal ve Metod: Bu çalışmada ki çalışma grubunu; Ocak 2006’ dan Aralık 2009’a kadar olan 4 yıllık bir süreçte, gestasyonel trombositopeniden (GT) dolayı hematoloji kliniğinde tedavi görmüş ve doğum yapmış 36 hasta oluşturmaktadır. Anneler ve onlara ait fetusler ile yeni doğanlar hamilelik ve lohusalığın erken dönemleri boyunca iç ve dış kanama (doğum şekli ile ilişkili durumlarda dahil-Normal doğumla sezeryan doğum karşılaştırılması) gibi belirtiler ve/veya semptomlar açısından geriye dönük olarak değerlendirilmiştir. Bulgular: Gestasyonel trombositopenili tüm vakalarda hastalık maternal ve perinatal morbidite ile ilgili olmaksızın, doğumun gidişatından bağımsız olarak başlangıçta ki trombosit sayısı< 75.000/ml. olduğu halde, komplike olmayan bir seyire sahiptir. Sonuç: Her ne kadar rastlantısal olarak eşlik eden neonatal trombositopeni gözardı edilemesede, gestasyonel trombositopeni durumunda maternal trombosit sayısının standardizasyonun postpartum dönemde gerçekleşmesi beklenmelidir. Bu gibi durumlarda fetal trombosit sayısının belirlenmesi veya sezeryan doğum gibi müdahaleler gerekmemektedir.
Keywords
References
- Kam PC, Thompson SA, Liew AC. Review article, thrombocytopenia in the parturient. Anaesthesia. 2004; 59:255–64.
- SullivanCA,MartinJNJr. Management of the obstetric patient with thrombocytopenia. Clin Obstet Gynecol. 1995; 38:521–34.
- Boehlen F, Hohlfeld P, Extermann P et al. Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol. 2000; 95: 29–33.
- Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom KD. Williams obstetrics, 21st edn. McGraw-Hill, Hematological disorders. 2001; 1307–38 [Chapter 49].
- Shehata N, Burrow RF, Kelton JG. Gestational thrombocytopenia. Clin Obstet Gynecol. 1999; 42:327–34.
- Michal Parnas, Eyal Sheiner , Ilana Shoham-Vardi, Eliezer Burstein, Tikva Yermiahu, Itai Levi, Gershon Holcberg, Ronit Yerushalmi. Moderate to severe thrombocytopenia during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006; 128:163–8.
- Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Semin Hematol. 2000; 37: 275–89.
- Burrows RF, Kelton GJ. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med. 1993; 329:1463–6.
- Silver RM, Branch DW, Scott JR. Maternal thrombocytopenia in pregnancy: time for a reassessment. Am J Obstet Gynecol. 1995;173:479–
- Nisha S, Amita D, Uma S, Tripathi AK, Pushplata S. Prevalence and Characterization of Thrombocytopenia in Pregnancy in Indian Women Indian J Hematol Blood Transfus. 2012; 28:77-81.
- Cook RL, Miller RC, Katz VL, Cefalo RC. Immune thrombocytopenic purpura in pregnancy: a reappraisal of management. Obstet Gynecol. 1991; 78: 578–83.
- Burrows RF, Kelton JG. Incidentally detected thrombocytopenia in healthy mothers and their infants. N Engl J Med. 1988; 319:142-5
- V. Kiefel, A. Greinacher. Differenzialdiagnose und Differenzialtherapie der Thrombozytopenie. Internist 2010;51:1397–1410.
- Yazışma Adresi / Address for Correspondence: Dr. Carlo Pafumi İstituto di Patologia Ostetrica e Ginecologica Santa Bambino Hospital Catania Universıty ITALY e mail: pafumi@unict.it geliş tarihi/received :07.08.2012 kabul tarihi/accepted:21.12.2012
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research |
| Authors | |
| Publication Date | September 1, 2013 |
| Published in Issue | Year 2013 Volume: 38 Issue: 3 |
