Occurence, etiology and clinical significanceof trombocytopenia in pregnancy


Authors: P. Brychtová 1;  M. Procházka 2,5;  V. Lattová 2;  M. Lubušký 2;  J. Procházková 3;  L. Slavík 3;  J. Úlehlová 3;  O. Šimetka 4
Authors‘ workplace: Porodnicko-gynekologické oddělení, Krajská nemocnice T. Bati, a. s., Zlín, přednosta MUDr . Z. Adamík, Ph. D. 1;  Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. 2;  Hematologicko-onkologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. K. Indrák, DrSc. 3;  Porodnicko-gynekologická klinika FN, Ostrava, přednosta doc. MUDr. V. Unzeitig, CSc. 4;  Ústav porodní asistence FZV UP, Olomouc, přednostka Mgr. V. Vránová, Ph. D. 5
Published in: Čes. Gynek.2013, 78, č. 6 s. 560-565
Category: Original Article

Overview

Objective:
The principal objective of the study is to compare results from the experimental group of pregnant women suffering from thrombocytopenia in pregnancy with results from the control group of pregnant women with normal physiologic blood platelet count.

Setting:
Department of Obstetrics and Gynaecology of the Tomas Bata Regional Hospital Zlín, Obstetrics and Gynaecology Clinic, Haematology and Oncology Clinic of the Palacky University Teaching Hospital and Medical School in Olomouc, Obstetrics and Gynaecology Clinic of the Ostrava Teaching Hospital.

Methodology:
A group of 200 pregnant women suffering from thrombocytopenia underwent thorough medical tests. The level of platelets, presence of anti-platelets agents, liver function (LFT), anti-phospholipid antibodies, complete blood count with differential, specific antibodies for hepatitis B and C, Lyme borreliosis and cytomegalovirus were determined from venous blood using the EIA, ELISA methods.

Results:
Medical articles and books about thrombocytopenia divide the causes for thrombocytopenia as follows: 79.5% benign gestational thrombocytopenia, 16% preeclampsia, 2.5% HELLP syndrome, 1% immune thrombocytopenia, 1% HVC. The number of women who developed physiological anaemia in pregnancy and were overweight is identical in the experimental group of pregnant women suffering from thrombocytopenia and in the control group of pregnant women with normal physiologic blood platelet count, and the proportion of the different age groups in the two groups of pregnant women is also identical.

Conclusion:
32% of pregnancies in the experimental group ended in a caesarean section, of which 13.5% in a group of 127 pregnant women suffering from mild thrombocytopenia, 17.5% in a group of 71 pregnant women suffering from moderate thrombocytopenia and 1% in a group of 2 pregnant women suffering from severe thrombocytopenia. 20.5% pregnancies in the control group ended in caesarean section.

Keywords:
thrombocytopenia – pregnancy – management of labour


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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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