Thrombocytopenia in pregnancy: a single-center retrospective analysis of 91 cases
Thrombocytopenia in pregnancy: a single-center retrospective analysis of 91 cases
复制标题
妊娠期血小板减少症91例单中心回顾性分析
DOI：
10.11406/rinketsu.60.1525
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
一戸 辰夫
中科院分区：
文献类型：
--
作者：
杉原 清香;佐藤 健一;占部 智;一戸 辰夫
血小板减少症是妊娠期相对常见的并发症，报告的发生率为7%-11%。这种情况的原因是多种多样的，虽然最常见的病因是妊娠性血小板减少症（GT）（70%-80%），其次是HELLP综合征和免疫性血小板减少症（ITP）。为探讨妊娠期血小板减少症的临床特点，我们对我中心69例妊娠期血小板计数低于100× 109/l的91例孕妇进行了回顾性分析。有38例妇女先前诊断为血小板减少性疾病，如ITP或遗传性血小板疾病。在其余53个病例中，只有在分娩后才能作出诊断。我们分析了病程、孕产妇和围产期特征、血小板计数波动和妊娠结局。最终诊断为GT 38例，ITP 14例，其他原因1例。区分GT和ITP并不总是可行的，有时只能根据产后血小板计数的变化进行。在患有血小板减少症的孕妇中，分娩后仔细随访血小板计数波动对于区分ITP和GT至关重要。
Thrombocytopenia is a relatively common complication in pregnancy, with a reported frequency of 7%-11%. The causes of this condition are diverse, although the most common etiology is gestational thrombocytopenia (GT)(70%-80%), followed by HELLP syndrome and immune thrombocytopenia (ITP). To investigate the clinical features of thrombocytopenia during pregnancy, we conducted a retrospective analysis of 69 women at our center with 91 pregnancies in which the platelet count was below 100× 10 9/l. There were 38 cases in women with a prior diagnosis of thrombocytopenic diseases such as ITP or an inherited platelet disorder. In the remaining 53 cases, a diagnosis could be made only after delivery. We analyzed the disease course, maternal and perinatal characteristics, platelet count fluctuations, and pregnancy outcomes. The final diagnosis was GT in 38, ITP in 14, and other causes in 1. To distinguish between GT and ITP is not always feasible and can sometimes only be performed based on postpartum changes in the platelet count. In pregnant women with thrombocytopenia, careful follow-up of platelet count fluctuations after delivery is crucial to distinguish ITP from GT.