Thrombocytopenia Flashcards
1
Q
What affect does pregnancy have on platelet count?
A
hemodilution –> decreased platelets (commonly reach nadir of 120K)
2
Q
What level of platelets is concerning?
A
<150,000/mm^3
3
Q
What meds can decrease PLT count?
A
- ASA, tylenol, indomethacin
- ampicillin, PCN, bactrim
- heparin, dig, cyclosporin
4
Q
Describe gestational thrombocytopenia (GTP)
A
- vast majority of cases
- typically presents in 3rd tri; if before, r/o other causes
- most cases = 120K-140K/mm^3*
- asymptomatic
- little risk maternal/neonatal complications
- no thrombocytopenia outside pregnancy
5
Q
Describe immune thrombocytopenia (ITP)
A
- typically occurs during 1st tri
- PLT < 80K
- pregnancy does not cause or affect severity
- neonatal complications = rare
6
Q
How is thrombocytopenia dx’ed?
A
- CBC
- peripheral smear
- pt hx (r/o PEC, meds, family)
7
Q
How should abrupt onset of thrombocytopenia in 3rd tri be managed?
A
R/O preeclampsia and HELLP
8
Q
How should GTP be managed?
A
- no special interventions or therapy
- monitor for complications
- check PLTs weekly after 34wks
- check PLTs q1-3mo PP
- anesthesia okay if >80K
9
Q
How should ITP be managed?
A
- no pharm tx in 1st or 2nd tri unless PLT<30K or significant bleeding
- admit if PLT < 20K
- tx = glucocorticoids
10
Q
Describe neonatal alloimmune thrombocytopenia
A
- fetus inherits platelet antigens from FOB
- gestational carrier develops Abs to fetal Ags
- leads to fetal thrombocytopenia, +/- fetal intracranial hemorrhage
