Laparoscopic Splenectomy for the Treatment of Refractory Immune Thrombocytopenia in Pregnancy

Griffiths, Jill; Sia, Winnie; Shapiro, A M James; Tataryn, Ivanna V.; Turner, A. Robert

doi:10.1016/s1701-2163(16)30729-0

Cited by 90 publications

(25 citation statements)

References 16 publications

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“…Splenectomy may induce a remission and has been reported to be associated with few complications if performed during the second trimester, 29,30 when risks of anesthesia to the fetus are minimal and uterine size will not complicate the procedure. This approach may be useful for patients who remain refractory to therapy or who experience significant toxicity with other therapies.…”

Section: What Treatments Are Safe During Pregnancy?mentioning

confidence: 99%

How I treat thrombocytopenia in pregnancy

Gernsheimer

James

Stasi

2013

Blood

233

213

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A mild thrombocytopenia is relatively frequent during pregnancy and has generally no consequences for either the mother or the fetus. Although representing no threat in the majority of patients, thrombocytopenia may result from a range of pathologic conditions requiring closer monitoring and possible therapy. Two clinical scenarios are particularly relevant for their prevalence and the issues relating to their management. The first is the presence of isolated thrombocytopenia and the differential diagnosis between primary immune thrombocytopenia and gestational thrombocytopenia. The second is thrombocytopenia associated with preeclampsia and its lookalikes and their distinction from thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. In this review, we describe a systematic approach to the diagnosis and treatment of these disease entities using a case presentation format. Our discussion includes the antenatal and perinatal management of both the mother and fetus. (Blood. 2013; 121(1):38-47)

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Section: What Treatments Are Safe During Pregnancy?mentioning

confidence: 99%

How I treat thrombocytopenia in pregnancy

Gernsheimer

James

Stasi

2013

Blood

233

213

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“…5 A few cases of splenectomy were reported, performed in the second trimester only, as the risk is then lower. 6 In the case of our patient, steroids and supplements of microelements were introduced, while thorough diagnostic process excluded the most likely causes of thrombocytopenia. Due to poor therapeutic effect and significant anemia, the IVIG treatment was commenced while the results of bone marrow trephine biopsy were pending.…”

Section: Discussionmentioning

confidence: 88%

Successful obstetric and hematologic outcome of aplastic anemia in a pregnant Jehovah’s Witness

Jakiel

Ciebiera

Słabuszewska-Jóźwiak

et al. 2016

Int J Immunopathol Pharmacol

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“…4) Use of thrombopoietic agents such as eltrombopag or romiplostim have been studied, but there is still little experience in their use in pregnancy [2]. For cases refractory to conventional treatment or if treatment toxicities are unacceptable, splenectomy can be performed in the second trimester when fetal and anesthetic risks are minimal [18]. The BCSH has recommended the laparoscopic approach for splenectomy.…”

Section: Discussionmentioning

confidence: 99%

Immune (Idiopathic) Thrombocytopenic Purpura Diagnosed in Pregnancy: A Case Report and Review of Management

Huang

Tan

2015

J Med Cases

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Immune (idiopathic) thrombocytopenic purpura (ITP) is an uncommon, but important cause of thrombocytopenia in pregnancy. It is a diagnosis of exclusion, and management should be based on a multidisciplinary care approach. ITP is characterized by moderate-to-severe thrombocytopenia commonly diagnosed in the first or early second trimester of pregnancy. The severity of thrombocytopenia has adverse implications on both maternal and fetal well-being. This paper is based on a case seen and managed in our institution and aims to discuss the various causes of thrombocytopenia and its implications in pregnancy as well as management of ITP in pregnancy based on current evidence and guidelines.

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Laparoscopic Splenectomy for the Treatment of Refractory Immune Thrombocytopenia in Pregnancy

Cited by 90 publications

References 16 publications

How I treat thrombocytopenia in pregnancy

How I treat thrombocytopenia in pregnancy

Successful obstetric and hematologic outcome of aplastic anemia in a pregnant Jehovah’s Witness

Immune (Idiopathic) Thrombocytopenic Purpura Diagnosed in Pregnancy: A Case Report and Review of Management

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