Medical disorders in pregnancy.
Although there is still controversy regarding the management of these patients, the therapy and testing that is now available enables us to formulate a reasonable individualized management plan. The maternal platelet count should be monitored carefully during pregnancy and treated according to the prior information. In addition, platelet antibodies may assist in predicting more effectively the potentially affected fetuses. In these cases, deliveries by cesarean section should be considered. If a fetal scalp platelet count is possible at the onset of labor, this should be performed, and if the count is less than 50,000 per mm3, the fetus should be delivered by immediate cesarean section. Clearly, it is necessary to have facilities available for immediate cesarean section prior to performing the platelet count. The use of steroid therapy near term appears to have a beneficial effect on the neonatal platelet count and should be strongly considered. Further information relating to the neonatal effects of high-dose intravenous immunoglobulin therapy may indicate this as a preferential prophylactic form of fetal therapy that may be available prior to delivery.
Schwartz
D B
DB
Department of Obstetrics and Gynecology, Sinai Hospital of Detroit, Michigan.
D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis / Q000628:therapy*; D013923:Thromboembolism / Q000175:diagnosis / Q000628:therapy*