Blood:血小板减少性紫癜史的妇女怀孕时可不治疗

2016-07-18 phylis 译 MedSci原创

妊娠期免疫性血小板减少性紫癜(ITP)的治疗选择是有限,指导管理决策的指南缺乏。对两个三级中心的单胎妊娠妇女进行回顾性研究,比较静脉注射丙种球蛋白(IVIg)和糖皮质激素治疗特发性血小板减少性紫癜的效果。对195名妇女,235怀孕数据进行综述。137例(58%)妊娠不需要治疗。其余91例女性,98次妊娠的女性,47(48%)例免疫球蛋白治疗和51例糖皮质激素治疗作为初始治疗。出生时,两组母亲平均血

妊娠期免疫性血小板减少性紫癜(ITP)的治疗选择是有限,指导管理决策的指南缺乏。对两个三级中心的单胎妊娠妇女进行回顾性研究,比较静脉注射丙种球蛋白(IVIg)和糖皮质激素治疗特发性血小板减少性紫癜的效果。

对195名妇女,235例怀孕数据进行综述。137例(58%)妊娠不需要治疗。其余91名女性,98次的妊娠,47(48%)例免疫球蛋白治疗和51例糖皮质激素治疗作为初始治疗。出生时,两组母亲平均血小板计数之间没有差异(IVIG 69×109 / L vs 糖皮质激素77×109/L),接受血小板计数反应的母亲的比例没有差异(IVIG 38% vs 糖皮质激素 39%)。没有致命或严重的母体、胎儿或新生儿出血。血小板计数可用的203例新生儿中,56(28%)例血小板计数<150×109/ L,18(9%)例血小板计数<50×109/ L,受影响最严重的新生儿出生时血小板计数最低点,最低点血小板计数发生到出生后6天。两个新生儿发生颅内出血(最低点血小板计数135和18×109/L)。没有新生儿死亡。

有ITP史的妊娠妇女不需要治疗,静脉注射免疫球蛋白或糖皮质激素治疗ITP新生儿预后没有差异。

原始出处:

Sun D, Shehata N, et al. Corticosteroids compared to intravenous immune globulin for the treatment of immune thrombocytopenia in pregnancy. Blood. 2016 Jul 11.


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