Document Detail


Pregnancy in women with idiopathic thrombocytopaenic purpura.
MedLine Citation:
PMID:  12061285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Idiopathic thrombocytopaenic purpura (ITP) is a common haematological disorder in young women. The management of ITP in pregnancy is controversial, particularly with regards to the mode of delivery. To date, there is no systematic study of the outcome of these pregnancies in Singapore. AIM: To study the outcomes of pregnancies in Asian women with a proven diagnosis of ITP. MATERIALS AND METHODS: Retrospective study of 27 pregnancies in 18 women managed at the Singapore General Hospital from 1 January 1994 to 30 June 2001. RESULTS: The mean age of the women was 30 years (range, 20 to 41 years) and the mean parity was 1 (range, 0 to 3). Thrombocytopaenia (platelet count < 150 x 10(9)/L) occurred in 18 pregnancies (67%). There were 3 first trimester missed abortions (11%), 1 termination of pregnancy (4%), 1 stillbirth (4%) and 22 livebirths (81%) in this series. The mode of delivery was spontaneous vaginal in 14 women (64%), vacuum extraction in 2 women (9%), elective caesarean section in 5 women (23%) and emergency caesarean section in 1 woman (4%). All liveborn neonates were delivered in good condition at term. Neonatal thrombocytopaenia occurred in 4 neonates (18%). Two neonates had cord platelet counts of less than 50 x 10(9)/L and 1 required therapy with corticosteroids and intravenous immune globulins. No bleeding complications occurred in any of the neonates. CONCLUSION: Our experience supports the increasingly prevalent practice of managing pregnancies in women with ITP with a conservative approach to investigations and treatment. Caesarean sections should be performed for obstetric indications only, given the rarity of bleeding complications in the offspring of these women and the lack of evidence to support its role in the prevention of neonatal intracranial haemorrhage.
Authors:
K Devendra; L P Koh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  31     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-06-13     Completed Date:  2002-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  276-80     Citation Subset:  IM    
Affiliation:
Division of Fetal-Maternal Medicine, Department of Obstetrics and Gynaecology, Singapore General Hospital, Outram Road, Singapore 169608. dharkan@singnet.com.sg
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / etiology
Adult
Anti-Inflammatory Agents / pharmacology,  therapeutic use*
Asian Continental Ancestry Group
Cerebral Hemorrhage / congenital
Cesarean Section / statistics & numerical data
Delivery, Obstetric / methods*,  standards,  statistics & numerical data
Drug Therapy, Combination
Female
Fetal Blood / cytology
Fetal Death / etiology
Humans
Immunoglobulins, Intravenous / pharmacology,  therapeutic use*
Maternal Age
Parity
Platelet Count
Pregnancy
Pregnancy Complications, Hematologic / diagnosis,  therapy*
Pregnancy Outcome
Purpura, Thrombocytopenic, Idiopathic / complications,  congenital,  diagnosis,  therapy*
Retrospective Studies
Singapore
Splenectomy
Steroids
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Immunoglobulins, Intravenous; 0/Steroids

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