title: How I treat thrombocytopenia in pregnancy.
abstract: A mild thrombocytopenia is relatively frequent during pregnancy and has generally no consequences for either the mother or the fetus. Although representing no threat in the majority of patients, thrombocytopenia may result from a range of pathologic conditions requiring closer monitoring and possible therapy. Two clinical scenarios are particularly relevant for their prevalence and the issues relating to their management. The first is the presence of isolated thrombocytopenia and the differential diagnosis between primary immune thrombocytopenia and gestational thrombocytopenia. The second is thrombocytopenia associated with preeclampsia and its look-alikes and their distinction from thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. In this review, we describe a systematic approach to the diagnosis and treatment of these disease entities using a case presentation format. Our discussion includes the antenatal and perinatal management of both the mother and fetus.
authors.affiliation: Division of Hematology, University of Washington and Puget Sound Blood Center, Seattle, WA, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Gernsheimer
authors.forename: Andra H
authors.initials: AH
authors.lastname: James
authors.forename: Roberto
authors.initials: R
authors.lastname: Stasi
mesh_terms: D000328:Adult; D000465:Algorithms; D058846:Antibodies, Monoclonal, Murine-Derived; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000075202:Contraindications; D003613:Danazol; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D005323:Fetal Monitoring; D017359:HELLP Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007231:Infant, Newborn; D010951:Plasma Exchange; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy / Q000097:blood*; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D012008:Recurrence; D000069283:Rituximab; D013921:Thrombocytopenia / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003613:Danazol