Severe thrombocytopenia after contrast infusion in pregnancy.
BACKGROUND
Intravenous contrast-induced thrombocytopenia is a rare but potentially life-threatening complication in pregnancy.


METHODS
A 22-year-old woman, gravida 2 para 1, at 33 2/7 weeks of gestation presented with chest pain, shortness of breath, and tachycardia. A computed tomography angiogram was pursued to evaluate for pulmonary embolus. During contrast infusion the woman experienced facial flushing, throat tightening, and worsening dyspnea. Her platelet count was noted to decrease precipitously to 4,000/microliter several hours after the imaging study. With medical management and observation, the woman's platelet count steadily recovered without further exacerbation of thrombocytopenia during gestation.


CONCLUSIONS
Prompt recognition and therapy for intravenous contrast-induced thrombocytopenia during pregnancy are essential to optimize maternal-fetal outcome.
Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington 98430, USA.
Jill A
JA
McCaulley
Shad H
SH
Deering
Jason A
JA
Pates
D000792:Angiography / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000139:chemically induced*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000009:adverse effects
D003287:Contrast Media; D007479:Iopamidol