Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia

Payne, Susan D.; Resnik, Robert; Moore, Thomas R.; Hedriana, Herman L.; Kelly, Thomas F.

doi:10.1016/s0002-9378(97)70454-x

Cited by 135 publications

(94 citation statements)

References 21 publications

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“…Additionally, searching for reliable predictors of NITP, we conducted a review of a total of 22 reported cases of fetal or neonatal ICH with NITP secondary to maternal ITP published from 1960 to 2010 [4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. The result was summarized in Table IV.…”

Section: Resultsmentioning

confidence: 99%

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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Section: Resultsmentioning

confidence: 99%

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

et al. 2011

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“…Gernsheimer et al [21], recommend the use of corticosteroids or IVIG if platelet count falls below 20--30 × 10 9 /L. Some studies consider the following as important predictors of an increased risk of neonatal thrombocytopenia: maternal history of splenectomy, maternal platelet count of < 50 × 10 9 /L at some point during the pregnancy, and a previous pregnancy complicated with neonatal thrombocytopenia [23][24][25][26]. Noris et al [27], performed a multicenter, retrospective study evaluating 339 pregnancies in 181 women.…”

Section: Discussionmentioning

confidence: 99%

Fetal-maternal complications and their association with gestational thrombocytopenia

Elveđi-Gašparović

Beljan²,

Gverić-Ahmetašević³

et al. 2016

Ginekol Pol

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Objectives: Thrombocytopenia is defined as a platelet count of < 150 × 10 9 /L. It is a common hematologic abnormality during pregnancy. Evaluation and treatment of gestational thrombocytopenia can be both, expensive and invasive, and may result in an adverse outcome. The aim of our study was to investigate the incidence of perinatal complications in pregnancies complicated with gestational thrombocytopenia and to determine if the severity of maternal gestational thrombocytopenia implicates unfavorable perinatal outcome. Material and methods:Over a period of three years, we identified 50 patients with gestational thrombocytopenia: 38 with platelet count between 50-100 × 10 9 /L -classified as moderate thrombocytopenia, and 12 with platelet count of < 50 × 10 9 /L -classified as severe thrombocytopenia. Fifty women with normal platelet count constituted the control group. Maternal complications and neonatal outcomes were compared. Results:Neonatal thrombocytopenia occurred more often in pregnancies complicated with gestational thrombocytopenia (p = 0.041). Thrombocytopenia in previous pregnancy seems to be an important predicting factor for disease severity in the current pregnancy (p = 0.01). Conclusions:Gestational thrombocytopenia, even if severe, is not associated with adverse maternal or neonatal outcome. Moderate neonatal thrombocytopenia is more common in pregnancies complicated with severe gestational thrombocytopenia. The incidence of severe gestational thrombocytopenia is higher in patients with thrombocytopenia in previous pregnancy.

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“…17,18 However, more recent data do not support a correlation between fetal scalp platelet count and neonatal platelet count at birth and they provide evidence that percutaneous umbilical vein sampling is associated with a high incidence of complications. 19 Furthermore, the universal application of CS delivery to pregnant patients with immune-mediated thrombocytopenia has not been shown to decrease the incidence of intraventricular hemorrhage. 20 A review of 601 infants born to women with immune thrombocytopenia showed that severe neonatal thrombocytopenia was present in 72/601 (12%) and that the neonatal intracranial hemorrhage is extremely rare and unrelated to the mode of delivery.…”

Section: Gestational Vs Sle-associated Thrombocytopeniamentioning

confidence: 99%

Systemic Lupus Erythematosus-associated Thrombocytopenia in Pregnancy: Is Splenectomy Necessary at the Time of Delivery?

Martinelli¹,

Petrone²,

Granate³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia

Cited by 135 publications

References 21 publications

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

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

Fetal-maternal complications and their association with gestational thrombocytopenia

Systemic Lupus Erythematosus-associated Thrombocytopenia in Pregnancy: Is Splenectomy Necessary at the Time of Delivery?

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