Maternal thrombocytopenia in pregnancy: time for a reassessment.
Antiplatelet autoantibodies in women with autoimmune thrombocytopenic purpura can cause fetal thrombocytopenia and serious bleeding problems. Obstetricians have used fetal scalp sampling, cordocentesis, and cesarean delivery in this disorder to avoid fetal complications such as intracranial hemorrhage. Accumulating evidence indicates that the fetal risk of intracranial hemorrhage is much lower than initially reported. Moreover, these invasive tests and treatments are costly, cause morbidity, and have little effect in preventing neonatal bleeding complications. Therefore we suggest these interventions should no longer be used in the management of maternal thrombocytopenia.
Silver
R M
RM
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City 84132, USA.
Branch
D W
DW
Scott
J R
JR
D002543:Cerebral Hemorrhage / Q000209:etiology / Q000517:prevention & control; D002585:Cesarean Section; D017218:Cordocentesis / Q000009:adverse effects; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000628:therapy; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications