Immune thrombocytopenic purpura and pregnancy.
Immune thrombocytopenic purpura and pregnancy.
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免疫性血小板减少性紫癜和妊娠。
DOI：
10.1056/nejm198204083061402
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Schreiber,AD
中科院分区：
文献类型：
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作者：
Cines,DB;Dusak,B;Tomaski,A;Mennuti,M;Schreiber,AD
新生儿血小板减少症是免疫性血小板减少性紫癜（ITP）的一种潜在危及生命的并发症。我们追踪了23名有ITP病史（11名妇女）或临床活动性疾病（12名妇女）的孕妇，以描述新生儿血小板减少的相关因素，未观察到母亲和新生儿血小板计数之间的关系（P>0.5）。11名妇女分娩了血小板减少的儿童;抗血小板抗体可在每个母亲中检测到，包括5名在分娩时临床缓解的母亲。母亲血小板相关IgG水平不能作为新生儿血小板减少的危险因素（P>0.05）。而母血抗血小板抗体水平与新生儿血小板减少的发生及程度相关（P<0.005）。母体血小板计数和母体抗体水平之间的差异可能是特别显着的母亲接受类固醇或脾切除术，监测循环抗血小板抗体的水平可能有助于识别和管理的风险与ITP孕妇交付新生儿严重血小板减少症。（《新英格兰医学杂志》1982年; 306：826- 831）
Neonatal thrombocytopenia is a potentially life-threatening complication of immune thrombocytopenic purpura (ITP). We followed 23 pregnant women who had either a history of ITP (11 women) or clinically active disease (12 women) to delineate the factors responsible for neonatal thrombocytopenia.No relation was observed between maternal and neonatal platelet counts (P>0.5). Eleven women delivered thrombocytopenic children; antiplatelet antibodies were detectable in each mother, including five who were in clinical remission at delivery. The level of platelet-associated IgG in the mothers did not identify the neonates at risk for thrombocytopenia (P>0.05). However, the level of maternal circulating antiplatelet antibody correlated with both the presence and the extent of neonatal thrombocytopenia (P<0.005). A discrepancy between maternal platelet count and maternal antibody level may be especially notable in mothers treated with steroids or splenectomy.Monitoring the level of circulating antiplatelet antibody may help in identifying and managing pregnant women with ITP at risk of delivering neonates with serious thrombocytopenia. (N Engl J Med. 1982; 306:826–31.)