Cause
Up to 8% of pregnancies, typical >70,000 and two-thirds 130.000-150.000 asymptomatic, normalized after 8-12 weeks after delivery. Some suggest mild form for ITP (se below) No definite diagnostic tests distinguished from mild ITP, the mother should be monitored closely and epidural considered if platelets is above 50,000-80.000. ITP - Idiopathic (autoimmune) Thrombocytopenic (purpura)
Control every 2-4 weeks No epidural if < 80 Platelets < 50 Medical treatment with Prenisone 1-2 mg/kilo. Response after 3-7 days max. within 2-3 weeks. Intravenous immune Globulin (IVIG) response after 72 hours. Return to pre-treatment levels after 30 days. If < 20 thrombocytes, transfusion first (6-10 U). Splenectomy if failed steroid and immuno-globulin and platelets < 10.000 (1) ACOG Practice Bulletin Number 6, September 1999. (2) Burrows RF. Platelet disorders in pregnancy. Current Opinion in Obstetrics and Gynecology 2001, 13:115-119. (3) Gernsheimer T, McCrae KR. Immune thrombocytopenic purpura in pregnancy. Curr Opin Hematol, 2007 Sep;14(5): 574-80.. (3) Guideline. 1996 Blackwell Science Ltd. British Journal of Hematology 95: 21-26. (4) Nielson-Piercy C. Handbook of Obstetric Medicine published in the United Kingdom in 2002 by Martin Dunitz Ltd.
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