Idiopatic trombocytopenic purpura and pregnancy: The maternal and neonatal outcomes İdyopatik trompositopenik purpura ve gebelik: Maternal ve neonatal sonuçlar


Madazli R. , GEZER A. , Şal V., Bulut B., Çift T.

Jinekoloji ve Obstetrik Dergisi, cilt.21, sa.4, ss.179-183, 2007 (Diğer Kurumların Hakemli Dergileri) identifier

  • Cilt numarası: 21 Konu: 4
  • Basım Tarihi: 2007
  • Dergi Adı: Jinekoloji ve Obstetrik Dergisi
  • Sayfa Sayıları: ss.179-183

Özet

Objective: To reveal the maternal clinical characteristics and neonatal outcomes of the pregnancy with the diagnosis ofldiopatic trombocytopenic purpura (ITP). Materials and Method: The maternal and neonatal records of 21 pregnancies complicated with ITP between January 1997 and December 2006 were retrospectively reviewed. Results: Nine of 21 cases (43 %) had a diagnosis of ITP before pregnancy and 12 (57 %) during pregnancy. The mean gestational week during pregnancy was 25.4±11.1 (9-41). The mean duration of ITP was 68 (9-192) months for the cases diagnosed before pregnancy. The mean platelet count was significantly higher in the group diagnosed before pregnancy compared to the group diagnosed during pregnancy, both at application and during follow-up (197.222±174.319/mL vs 48.883±48.786/mL and 234.750±205. 602/mL vs 69.500±39.30/mL) (p<0.05). The platelet count at delivery and neonatal platelet count were similar in both groups. The mean platelet counts were found similar in cesarean and vaginal delivery groups. Eleven patients had paltelet counts below 100.000/mL during delivery (mean: 66100/mL). Only 4 (27 %) patients with mean platelet count 57.000/mL had significant postpartum bleeding. Three of them were delivered with cesarean and 1 delivered vaginally. These patients transfused total 4 units of platalets and 2 units of whole blood. Only one intrauterine death happened at 17th gestattional week. The mean platelet count of 15 newborns was 164.800±76.900/mL (27.000-113.000/mL). In 5 newborns, moderate trombocytopenia was observed with a mean platelet count of 76.400/mL (27.000-113.000/mL) and their mothers also had platelet counts below 100.000/mL (mean 61.000/mL). Only 1 newborn with platelet count 27.000/mL required medication with iv immunglobulin. Conclusion: The platelet count should be maintained with medications in pregnancies complicated with ITP and vaginal delivery should be prefered.