Title: A case of severe immune thrombocytopaenia presenting de novo in the first trimester of a third pregnancy
Abstract:<h3>Background</h3> Thrombocytopenia is a frequent finding in pregnancy. Thrombocytopenia may be gestational thrombocytopaenia, associated with systemic disease, or may indicate immune thrombocytopeni...<h3>Background</h3> Thrombocytopenia is a frequent finding in pregnancy. Thrombocytopenia may be gestational thrombocytopaenia, associated with systemic disease, or may indicate immune thrombocytopenia (ITP). The latter complicates 1-2 in 1,000 pregnancies and whilst it accounts for only 5% of cases of thrombocytopaenia in pregnancy, it can be associated with maternal and neonatal morbidity. <h3>Case report</h3> A 34 year old G 3 P, Mrs J, presented at 8/40 gestation with a petechial rash. A full blood count showed thrombocytopenia (platelet count 10x109/L), with a normal blood film. A diagnosis of ITP was made and she was commenced on Prednisolone 80mg daily. Within 48 hours of admission she developed a left sided headache; a CT scan revealed a left sided extradural haematoma. She received a platelet transfusion and a 2 day course of IV Immunoglobins. Mrs J responded well and her headache resolved. Steroids were reduced to 5-20mg to maintain a count above>100 x109/L. She presented in labour at 36 weeks gestation, deliveringa male infant weighing 2.94Kg, with a normal cord platelet count. Blood loss at delivery was 350mls. Mrs J remains well with platelets of 110-150 x109/L on low dose prednisolone. <h3>Discussion</h3> Management of ITP in pregnancy depends on platelet count and haemorrhagic tendency, aiming to optimise platelet count for delivery. It is not uncommon to manage women with platelet counts < 20 x 109/l conservatively until late second trimester, having established steroid responsiveness. Maternal thrombocytopenia can be associated with neonatal thrombocytopenia although absolute levels do not correlate.Read More
Publication Year: 2012
Publication Date: 2012-04-01
Language: en
Type: article
Indexed In: ['crossref']
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot