[Autoimmune thrombocytopenia and pregnancy]. 1987

B J Paniel, and J B Truc, and P Poitout

Idiopathic thrombocytopenic purpura is an auto-immune disease that carries a risk of haemorrhage when the number of platelets drops to lower than 50 X 10(9)/l and particularly when the bleeding time is prolonged. Thrombocytopenic purpura and pregnancy can be associated with one another and the frequency of that is about 1/5000. Maternal mortality and morbidity are, however, practically nil when proper therapeutic measures are taken. Since 1981 IG IV, which is expensive but rapidly effective, is available to overcome corticotherapeutic failures and to avoid splenectomy in acute cases. Since the maternal anti-platelet factor can cross the placenta, the fetus may become thrombocytopenic like the mother and at risk of the complications of haemorrhage and particularly intra-cranial haemorrhage during delivery vaginally. Screening for fetuses that are affected (52% of the cases) is now possible, not by relying on the maternal platelet count, which is without any prognostic value for the fetus, nor on the levels of anti-platelet antibodies but on the use of examining fetal scalp capillary blood at the onset of labour. This test may make it possible to carry out a vaginal delivery safely when the fetal platelet count is higher than 50 X 10(9)l, whereas if it is lower than this figure a prophylactic caesarean operation should be carried out. There is much promise in the possibility of sampling blood in the fetal cord using ultrasound techniques. In a small number of cases that has already made it possible to diagnose the condition of thrombocytopenia in the fetus even before labour has started. It may in the future even make it possible to carry out treatment of the fetus in utero followed by a normal delivery, whether the treatment is carried out by treating the mother or directing platelets or better still IG IV directly into the fetal circulation.

UI MeSH Term Description Entries
D007116 Immunization, Passive Transfer of immunity from immunized to non-immune host by administration of serum antibodies, or transplantation of lymphocytes (ADOPTIVE TRANSFER). Convalescent Plasma Therapy,Immunoglobulin Therapy,Immunotherapy, Passive,Normal Serum Globulin Therapy,Passive Antibody Transfer,Passive Transfer of Immunity,Serotherapy,Passive Immunotherapy,Therapy, Immunoglobulin,Antibody Transfer, Passive,Passive Immunization,Therapy, Convalescent Plasma,Transfer, Passive Antibody
D007744 Obstetric Labor Complications Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both. Complications, Labor,Labor Complications,Complication, Labor,Complication, Obstetric Labor,Complications, Obstetric Labor,Labor Complication,Labor Complication, Obstetric,Labor Complications, Obstetric,Obstetric Labor Complication
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011250 Pregnancy Complications, Hematologic The co-occurrence of pregnancy and a blood disease (HEMATOLOGIC DISEASES) which involves BLOOD CELLS or COAGULATION FACTORS. The hematologic disease may precede or follow FERTILIZATION and it may or may not have a deleterious effect on the pregnant woman or FETUS. Complications, Hematologic Pregnancy,Hematologic Pregnancy Complications,Pregnancy Complications, Hematological,Pregnancy, Hematologic Complications,Complication, Hematologic Pregnancy,Complication, Hematological Pregnancy,Complications, Hematological Pregnancy,Hematologic Pregnancy Complication,Hematological Pregnancy Complication,Hematological Pregnancy Complications,Pregnancies, Hematologic Complications,Pregnancy Complication, Hematologic,Pregnancy Complication, Hematological
D011696 Purpura, Thrombocytopenic Any form of purpura in which the PLATELET COUNT is decreased. Many forms are thought to be caused by immunological mechanisms. Purpura, Thrombopenic,Purpuras, Thrombocytopenic,Purpuras, Thrombopenic,Thrombocytopenic Purpura,Thrombocytopenic Purpuras,Thrombopenic Purpura,Thrombopenic Purpuras
D001803 Blood Transfusion The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed) Blood Transfusions,Transfusion, Blood,Transfusions, Blood
D005260 Female Females
D005315 Fetal Diseases Pathophysiological conditions of the FETUS in the UTERUS. Some fetal diseases may be treated with FETAL THERAPIES. Embryopathies,Disease, Fetal,Diseases, Fetal,Embryopathy,Fetal Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000305 Adrenal Cortex Hormones HORMONES produced by the ADRENAL CORTEX, including both steroid and peptide hormones. The major hormones produced are HYDROCORTISONE and ALDOSTERONE. Adrenal Cortex Hormone,Corticoid,Corticoids,Corticosteroid,Corticosteroids,Cortex Hormone, Adrenal,Hormone, Adrenal Cortex,Hormones, Adrenal Cortex

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