Quantitative and qualitative platelet abnormalities during pregnancy

How, Helen; Bergmann, F.; Koshy, Mabel; Chediak, Juan; Presperin, Celeste; Gall, Stanley A.

doi:10.1016/0002-9378(91)90634-4

Cited by 8 publications

(2 citation statements)

References 13 publications

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“…Although the pathogenesis of GT has not yet been determined, accumulating clinical experience indicates that GT is of limited obstetric or hematologic signi cance, either to the mother or to the newborn. However, the basis for this perception is derived from studies using the standard cutoff value of 150,000/ mm 3 for de ning thrombocytopeni a [4,5,8,9,12,13]. Our study using a cutoff value of 100,000/ mm 3 showed GT was virtually asymptomatic during pregnancy and delivery, and there was no severe neonatal thrombocytopenia .…”

Section: Discussionmentioning

confidence: 91%

Obstetric prognosis of the gestational thrombocytopenia

Song

Kim

2001

Haematologia

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To define clinical outcomes of marked gestational thrombocytopenia (GT) (<100,000/mm3) we identified twenty-nine infants born to 28 pregnancies at 26 women with GT among 8,364 deliveries during the years 1993- 1999. Cordocentesis was performed in 7 mothers with platelet counts less than 75,000/mm3. Cord blood platelet count was checked in all cases at delivery. The most significant decrease of platelet count in pregnancy with GT was less than 50,000/mm3 in 6 pregnancies (21.4%) and between 50,000 and 100,000/mm3 in 22 pregnancies (78.6%). In pregnancies with GT, 2 neonates (6.9%) had mild thrombocytopenia and 1 neonate (3.4%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with GT. There were no cases of coagulation disturbance at delivery or in the postpartum period. Fourteen cases for which follow-up was carried out recovered platelet counts to more than 100,000/mm3 within one month postpartum. Two patients who became pregnant twice noticed recurrence of GT. In conclusion, GT is not associated with bleeding diathesis in the mother, resolves spontaneously during the postpartum period, and can recur in subsequent gestations, and the association of severe fetal/neonatal thrombocytopenia is very rare. No intervention is necessary during pregnancy or delivery, apart from a careful maternal and fetal surveillance if there is no obstetric indication.

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Section: Discussionmentioning

confidence: 91%

Obstetric prognosis of the gestational thrombocytopenia

Song

Kim

2001

Haematologia

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“…Specific autoantibodies are considered to be the hallmark of autoimmunity. Women with AITP cannot be distinguished from those with gestational thrombocytopenia using one or more of the prototypic platelet antiglobulin tests currently available (platelet‐associated IgG, platelet‐associated C3, platelet‐associated IgM or platelet‐bindable IgG, M and C3 in plasma) (Kaplan et al , 1990; How et al , 1991). In contrast, specific antibodies detected by antigen capture assays (including monoclonal antibody immobilization of platelet antigens or MAIPA) were rarely detected in women with gestational thrombocytopenia (Lescale et al , 1996).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy‐associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype

Gandemer¹,

Kaplan

Quelvennec

et al. 1999

Br J Haematol

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Summary. In a prospective study between 1993 and 1998, data was collected from 46 pregnant women and subsequently from their babies. 25 pregnant women with active autoimmune thrombocytopenic purpura (AITP) or a history of AITP (group A) and 21 pregnant women with isolated thrombocytopenia and identification of specific platelet autoantibodies detected by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay (group B) were evaluated for platelet-associated immunoglobulin-G (PAIgG), MAIPA assay and HLA genotype. Neonatal platelet counts were performed at least three times in the first week. 11 neonates were thrombocytopenic (23·9%). No severe haemorrhage occurred. There were no significant differences regarding the values of PAIgG or positive MAIPA tests between mothers of thrombocytopenic or healthy newborns. A significant difference, however, regarding the HLA DRB3* allele was found, with a high incidence in the subgroup of mothers of healthy newborns (P ¼ 0·005). A similar trend was found among mothers with anti-GPIIbIIIa antibodies (P ¼ 0·06). In contrast, HLA DRB5* allele appeared to be present especially in mothers of thrombocytopenic newborns (not significant). Our data suggest that mothers with AITP who have the HLA DRB3* genotype are unlikely to give birth to a thrombocytopenic baby. This study provides a preliminary report on a noninvasive test to identify infants who are likely to be affected.

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Coagulation Defects

Letsky¹

2002

Medical Disorders in Obstetric Practice

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Quantitative and qualitative platelet abnormalities during pregnancy

Cited by 8 publications

References 13 publications

Obstetric prognosis of the gestational thrombocytopenia

Obstetric prognosis of the gestational thrombocytopenia

Pregnancy‐associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype

Coagulation Defects

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