Primary autoimmune thrombocytopenia in pregnancy: maternal and neonatal outcomes

Huseyin Ekici, Fırat Ökmen, Didem Gul Saritas, M. Imamoglu, Turnagül Eker, A. Ergenoğlu
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Abstract

Aim: To evaluate clinical characteristics, maternal and neonatal outcomes among pregnant women with primary autoimmune thrombocytopenia (ITP). Materials and methods: All pregnant women with ITP who had undergone antenatal follow-up and delivery at the Department of Obstetrics and Gynecology at a referral center, between 2011 and 2021, were retrospectively investigated. Patients were evaluated in three groups according to antenatal treatment modality. Results: 42 pregnant women with ITP were included in the study. A total of 29 (%69) pregnant womenhad been diagnosed with ITP before pregnancy and 13(%31) were diagnosed during pregnancy. 17 (%41) pregnant women did not receive any antenatal treatment, and 25 (%59) pregnant women receieved treatment. Postpartum haemorrhage (%50) was reported more frequently in the steroids+IVIG group. A total of 42 pregnancies, 43 babies (one twin pregnancy, 41 singletons) were liveborn. Three neonates (%7) had thrombocytopenia and one of them had intracranial haemorrhage. Conclusions: In pregnancies complicated with ITP, the platelet count is moderately or severely low, which can have adverse maternal and neonatal outcomes. Postpartum haemorrhage is a significant cause of maternal morbidity in cases with ITP. Therefore, pregnant women with ITP should be delivered in facilities that can adequately manage postpartum haemorrhage.
妊娠期原发性自身免疫性血小板减少症:母婴结局
目的:评估原发性自身免疫性血小板减少症(ITP)孕妇的临床特征、孕产妇和新生儿结局。材料和方法:对2011年至2021年间在转诊中心妇产科接受产前随访和分娩的所有ITP孕妇进行回顾性调查。根据产前治疗方式将患者分为三组进行评估。结果:42例ITP孕妇被纳入研究。共有29名(%69)孕妇在怀孕前被诊断为ITP,13名(%31)孕妇在妊娠期间被诊断为ITP。17名(%41)孕妇未接受任何产前治疗,25名(%59)孕妇接受了治疗。类固醇+IVIG组的产后出血(%50)发生率更高。共有42例妊娠,43例婴儿(一例为双胞胎妊娠,41例为单身)为活产。三名新生儿(%7)有血小板减少症,其中一名有颅内出血。结论:在合并ITP的妊娠中,血小板计数中度或重度低,这可能会对母体和新生儿产生不利影响。产后出血是ITP产妇发病的重要原因。因此,患有ITP的孕妇应在能够充分管理产后出血的设施中分娩。
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