title: Autoimmune thrombocytopenic purpura: maternal and fetal disease.
abstract: We have followed up 63 pregnancies in women with autoimmune thrombocytopenic purpura (ATP). Of these, 15 were previously splenectomized. The characteristics of the sample can be summed up as follows: average age 27 years (17-41); platelets at the beginning of pregnancy, mean 129.5 x 10(9)/l (range 16-488); platelets at delivery, mean 133 x 10(9)/l (range 8-477); PA-IgG at delivery, mean 320 ng IgG/10(7) platelets (range 10-1000); SPB-IgG at delivery, mean 262 ng IgG/10(7) platelets (range 10-1000). There were 30 spontaneous deliveries and 33 cesarean sections. Forty-two newborns had a platelet count within the normal range while nine had a platelet count less than or equal to 150 x 10(9)/l, while six had less than or equal to 100 x 10(9)/l and a further six less than or equal to 50 x 10(9)/l. The aim of this study is the evaluation of maternal risk and of possible feto-neonatal thrombocytopenia at birth. In this regard, the following parameters were considered: previous maternal splenectomy; the platelet count at the beginning of pregnancy; the platelet count and the titres of PA-IgG and SPB-IgG at delivery. Preliminary statistical evaluation of these parameters enabled us to identify a risk score. From this it was possible to obtain an optimum management of the final stage of pregnancy regarding the therapeutic approach and the timing of delivery.
authors.affiliation: Institute of Puericulture, University of Rome, La Sapienza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pachì
authors.forename: E
authors.initials: E
authors.lastname: Carapella
authors.forename: M G
authors.initials: MG
authors.lastname: Mazzucconi
authors.forename: G M
authors.initials: GM
authors.lastname: Gandolfo
authors.forename: R
authors.initials: R
authors.lastname: Paesano
authors.forename: V
authors.initials: V
authors.lastname: Petrelli
authors.forename: V
authors.initials: V
authors.lastname: De Sanctis
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases / Q000097:blood*; D006470:Hemorrhage / Q000097:blood / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000276:immunology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000150:complications / Q000276:immunology; D012307:Risk Factors; D013154:Spleen / Q000276:immunology; D013156:Splenectomy