Thrombocytopenia Flashcards
Thrombocytopenia in pregnancy
Incidence
10 % of prenancy
Thrombocytopenia in pregnancy
causes
1 - autoimmune most important (SLE)
2 - HELLP in preeclamptic woman
3 - won willibrand diseases
4 - Gestational thrombocytopenia
Thrombocytopenia in pregnancy
The most common cause, how much proportion
Gestational thrombocytopenia
80 %
Gestational thrombocytopenia
how much low platelet drop
- never below 90 thousand
- if <90 k , think other diagnosis
Gestational thrombocytopenia
complications
- benign
- no fetal maternal complications
Gestational thrombocytopenia
treatment
- no treatment
- self limiting
- only follow up
Thrombocytopenia in pregnancy
if < 90 k platelet
- ITP (almost )
ITP in pregnancy
incidence
1-2/10,000
when gestational thrombocytopenia and ITP start in prenancy
Gestational thrombocytopenia: > 20 weeks
ITP in pregnancy: starts < 20 weeks
ITP in pregnancy
how much low platelet drop
- marked
- safety margins to be met for specific situation
Thrombocytopenia in pregnancy
safety cutoffs
If not within safety margin then what
for normal vainal delivery: 20 K
for CS: 50 K
for regional anesthesia: 80 k
for starting platelet transfusion: 75 k
If not within safety margin: then transfusion not steroids
ITP
antiplatelet antibodies
incidence
Implication
5- 10 % cases can cross placenta and cause thrombocytopenia in baby Bleeding disorder so no instrument specially ventouse no FBS
ITP in pregnancy
treatment according to levels
- Steroids treatment
- If fail then immuno suppressant treatment
- IVIG
Transfusion only if symptomatic (eccymosis) after controlling immunity
immuno suppressant treatment safe in pregnancy
- prednisolone
- cyclosporin
- Tacrolimus (T cells)
immuno suppressant treatment not safe in pregnancy
Mycophenolate mefetil
Used in transplantation specially renal
