THE DETERMINANTS IN THE MANAGEMENT OF PREGNANCIES COMPLICATED WITH IMMUNE THROMBOCYTOPENIA
Küçük Resim Yok
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: This study aims to determine the hematologic and obstetric factors that would affect the management of immune thrombocytopenia (ITP) during pregnancy. Material and Method: This is a retrospective review of 54 preg- nancies that were complicated by ITP at a single tertiary center. All of the patients were followed-up and delivered at the same cen- ter. Subgroup analysis for obstetric outcomes was made accord- ing to the platelet counts at the time of delivery (<50x103/mm3 or ?50x103/mm3), the time of diagnosis (before or during pregnancy) and neonatal platelet counts (?100x103/mm3 or >100x103/mm3). Result: Transfusion of blood products, steroid administration per se, or in combination with intravenous immunoglobulins (IVIG), were significantly more often administered in those with platelet counts <50x103/mm3 at the time of delivery (p=0.020, p=0.020, and p=0.004, respectively). The patients who were first diag- nosed with ITP during pregnancy had higher rates of transfusion of blood products (p=0.041), higher rates of vaginal deliveries (p=0.048), and lower rates of preterm delivery (p=0.044) when compared to the patients who had ITP diagnosed before the onset of pregnancy. Gestational age at birth (p=0.020), birth weight (p=0.002) and neonatal platelet count (p=0.002) were significant- ly higher in those who were diagnosed during the pregnancy. History of maternal splenectomy, intensive care unit admission, IVIG administration, and blood transfusion were significantly more frequent in neonates with platelet counts ?100x10 3/mm3 (p=0.028, p=0.001, p=0.001, and p=0.025, respectively). Conclusion: The women diagnosed with ITP before the preg- nancy and those who were diagnosed during the pregnancy had comparable rates of postpartum bleeding. However, there was a tendency towards overtreatment of the women who developed ITP during pregnancy.
Açıklama
Anahtar Kelimeler
Pregnancy, bleeding, Immune thrombocytopenia
Kaynak
İstanbul Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
86
Sayı
4
