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Clinical Control Study of Pregnancy Associated Thrombocytopenia and Pregnancy Complicated with Idiopathic Thrombocytopenic Purpura

Author: LiuZhiJun
Tutor: ShenJianKai
School: Central South University
Course: Internal Medicine
Keywords: pregnancy idiopathic thrombocytopenic purpura pregnancy associated thrombocytopenia
CLC: R714.2
Type: Master's thesis
Year: 2007
Downloads: 143
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Abstract


Objective Thrombocytopenia is an ordinary complication in pregnancy, which can cause postpartum hemorrhage and intracranial hemorrhage of newborn. It was mainly caused by pregnancy associated thrombocytopenia (PAT), pregnancy-induced hypertension syndrome (PIH) and pregnancy complicated with idiopathic thrombocytopenic purpura (PCITP). PAT and PCITP are these two class diseases that are hard to be differential diagnosis. The objective of this research is to explore the identification of them through systematically comparing their clinical manifestations and laboratory examination.Results After Collecting cases data of group PAT and group PCITP and comparing their clinical manifestations and laboratory examination, all data were analyzed statistically.Methods 1. Thrombocytopenia in Group PAT usually becomes evident in the last two trimesters. Platelet count usually more than 50×10~9/L and recovered to normal in one week after delivery. The symptoms of bleeding of PAT are uncommon. Thrombocytopenia in Group PCITP usually becomes evident before pregnancy and during early pregnancy. Platelet count usually less than 50×10~9/L and scarcely recovered after delivery. The symptoms of bleeding of PAT are common. 2.After we compared group PCITP with group PAT, the index of MPV, PDW, P-LCR in group PCITP is increased and the index of HGB, MCV, MCH, MCHC is decreased (P＜0.01). 3. Megakaryocytes of bone marrow of group PAT are normal. The count of megakaryocytes of bone marrow of group PCITP is increased and often complicated with megakaryocyte mature hindrance. 4. The amount of postpartum hemorrhage of group PCITP and group PAT are not obvious difference when platelet count more than 20×10~9/L, but the amount of postpartum hemorrhage of group PCITP is increased significantly if platelet count less than 20×10~9/L.Conclusion 1. We can identify PAT and PCITP through the term of occurrence of thrombocytopenia, the degree of thrombocytopenia, the change of platelet parameter, the examination of bone marrow, postpartum hemorrhage and platelet count recovered after delivery or not. 2. Therapy is necessary for severe PCITP, but it may be unnecessary for PAT。3. Prenatal platelet count between (20-50)×10~9/L is safety threshold for PAT and PCITP. When platelet count of PCITP less than or equal to 20×10~9/L without severe bleeding tendency, vaginal delivery should be considered. And vaginal delivery is a safety Mode of delivery for PAT.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy )
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