Idiopathic thrombocytopenic purpura and pregnancy

Tancer, M.Leon

doi:10.1016/0002-9378(60)90375-6

Cited by 37 publications

(4 citation statements)

References 31 publications

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“…There are reports of complete remission during pregnancy [5]. However, Tancer [7] in his review of 54 cases from the literature re ports 4 cases of maternal death during pregnancy.…”

Section: Results (1 ) the Influence O F P Regn An Cy On The Course O mentioning

confidence: 99%

“…Both Tancer [7] and H eyes [2] reach the conclusion that maternal prognosis is improved if splenectomy has been performed prior to pregnancy. In our series, 9 of the 12 cases did not have splenectomy.…”

Section: Discussionmentioning

confidence: 99%

“…As far as the prognosis of pregnant women with idiopathic thrombocytopenia is concerned, Burnett and K lass in 1943 [1], Robson and Davidson in 1950 [6] as well as Tancer in 1960 [7], in their extensive reviews, concur that maternal mortality wras not higher than what could be expected from the thrombocytopenia itself.There is little evidence in the literature that pregnancy influenced the course of the disease. In view of the increased corticoid excretion of the placenta, it should be expected that the thrombocytopenia would improve with pregnancy.…”

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confidence: 99%

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Idiopathic Thrombocytopenia in Pregnancy

Schenker¹,

Polishuk²

1968

Gynecol Obstet Invest

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“…There are reports of complete remission during pregnancy [5]. However, Tancer [7] in his review of 54 cases from the literature re ports 4 cases of maternal death during pregnancy.…”

Section: Results (1 ) the Influence O F P Regn An Cy On The Course O mentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Idiopathic Thrombocytopenia in Pregnancy

Schenker¹,

Polishuk²

1968

Gynecol Obstet Invest

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“…Where the risk of fetal mortality or morbidity is low, delivery by cesarean section rather than vaginally is obviously of no great advantage to the fetus. Although perinatal mortality and morbidity in cases of ITP are reportedly as high as 15-25% [19][20][21], approximately 50% of the deaths in such cases occur before the onset of labor [8,15], We would, therefore, urge that closer atten tion should be focused on those physiological mecha nisms and events during pregnancy and labor which account for these high rates of perinatal mortality and morbidity where the mother has a history of ITP. At the same time we strongly oppose subjecting the mother to further risks by unnecessarily opting for operative deliv ery.…”

Section: Discussionmentioning

confidence: 99%

Management of Labor in Patients with Idiopathic Thrombocytopenic Purpura

Dan

Barkai

David

et al. 1989

Gynecol Obstet Invest

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Transient thrombocytopenia may occur in infants born to mothers with idiopathic thrombocytopenic purpura, suggesting transplacental passage of the antiplatelet factor. Labor in women with idiopathic thrombocytopenic purpura calls for a special management. Irrespective of the maternal platelet count, we believe that labor should be conducted vaginally but reassessed after a thrombocyte count of fetal scalp blood. Maternal thrombocytopenia, which may indicate a possible risk of coagulopathy, should be treated aggressively and followed up with replacement therapy. Percutaneous umbilical sampling is to be avoided because it carries an immediate risk of fetal and maternal complications. A count of 50,000/mm³, obtained early during the course of labor, may be taken as a threshold indicator for abdominal delivery via cesarean section.

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Reliable predictors of neonatal immune thrombocytopenia in pregnant women with idiopathic thrombocytopenic purpura

et al. 2011

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Of infants born to women with idiopathic thrombocytopenic purpura (ITP), about 10-15% have transient neonatal immune thrombocytopenic purpura (NITP). Of concern is the lack of a reliable predictor for NITP. We conducted a retrospective study of all pregnancies with ITP at Osaka University Hospital over the past 16 years analyzing a total of 127 pregnancies in 88 women with ITP to assess the predictive value of various clinical factors regarding neonatal platelet count in the current pregnancy. We also reviewed the literature concerning ITP in pregnancy and NITP prediction. Neonatal platelet counts were less than 100 3 10 9 /L in 20 of 130 neonates (15.4%), less than 50 3 10 9 /L in 11 neonates (8.5%), and less than 20 3 10 9 /L in three neonates (2.3%). There was a strong correlation between the first and second sibling regarding the occurrence and the severity of NITP with Spearman correlation coefficient of 0.55 (P 5 0.001) at birth and 0.63 (P < 0.0001) at nadir after birth. A maternal platelet count less than 100 3 10 9 /L at delivery showed a statistical trend for an association with the occurrence of NITP (P 5 0.043). Moreover, maternal ITP refractory to splenectomy correlated with a higher risk for fetal or neonatal ICH according to the review of the literature. In conclusion, pregnant women who have had a previous offspring with NITP or who have ITP refractory to splenectomy may be at particular risk of delivering an offspring with significant NITP. Management decisions, including mode of delivery, may be altered by the degree of risk for potentially severe NITP. Am. J. Hematol. 87:15-21, 2012. V

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Idiopathic thrombocytopenic purpura and pregnancy

Cited by 37 publications

References 31 publications

Idiopathic Thrombocytopenia in Pregnancy

Idiopathic Thrombocytopenia in Pregnancy

Management of Labor in Patients with Idiopathic Thrombocytopenic Purpura

Reliable predictors of neonatal immune thrombocytopenia in pregnant women with idiopathic thrombocytopenic purpura

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