medigraphic.com
ISSN 1561-2996 (Digital)
ISSN 0864-0289 (Impreso)

2014, Número 3

<< Anterior Siguiente >>

Rev Cubana Hematol Inmunol Hemoter 2014; 30 (3)


Trombocitopenia en el embarazo: gestacional, inmune y congénita

Cabrera PY, Castillo GD

Idioma: Español
Referencias bibliográficas: 42
Paginas: 196-207
Archivo PDF: 135.74 Kb.


RESUMEN

La trombocitopenia afecta hasta el 10 % de todos los embarazos y es un diagnóstico común y un problema en el manejo de las pacientes, ya que puede estar relacionado con condiciones prexistentes presentes en las mujeres en edad fértil, como la trombocitopenia inmune primaria y las trombocitopenias congénitas; o con trastornos intrínsecos del embarazo, como la trombocitopenia gestacional. Se recomienda que todas las mujeres embarazadas con recuento de plaquetas por debajo de 100 × 109/L sean sometidas a una evaluación por el hematólogo y el obstetra. El análisis cuidadoso del momento del inicio de la trombocitopenia asociado a las manifestaciones clínicas y las pruebas de laboratorio específicas, es indispensable para proporcionar un diagnostico apropiado y una asistencia médica materna-fetal en el momento oportuno, en preparación para el desafío homeostático.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Blood. 2013;121(1):38-47.

  2. Bockenstedt PL. Thrombocytopenia in Pregnancy. Hematol Oncol Clin N Am. 2011 Apr;25(2):293-310. doi:10.1016/j.hoc.2011.01.004

  3. Jensen JD, Wiedmeier SE, HenryE, Silver RM, Christensen RD. Linking maternal platelet counts with neonatal platelet counts and outcomes using the data repositories of a multihospital health care system. Am J Perinatol. 2011 Sep;28(8):597-604. Epub 2011 May 3.

  4. Fay RA, Hughes AO, Farron N.T. Platelets in pregnancy: hyperdestruction in pregnancy. Obstetrics & Gynecology. 1983 Feb;61(2):238-40.

  5. Tsunoda T, Ohkuchi A, Izumi A, Watanabe T, Matsubara S, Sato I, et al. Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies. Acta Obstet Gynecol Scand. 2002 Sep;81(9):840-5.

  6. Calderwood C. Thromboembolism and thrombophilia in pregnancy. Current Obstet Gyneacol. 2006;16: 321-6. doi:10.1016/j.curobgyn.2006.09.001

  7. Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. Br J Haematol. 2012 Jul;158(1):3-15. doi:10.1111/j.1365- 2141.2012.09135

  8. Win N, Rowley M, Pollard C, Beard J, Hambley H, Booker M. Severe gestational (incidental) thrombocytopenia: to treat or not to treat. Hematology. 2005 Feb;10(1):69-72.

  9. Neunert C, Lim W, Crowther M, Cohen A, Solberg L Jr, Crowther MA. The American Society of Hematology 2011 evidencebased practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190-207.

  10. Kelton J. Idiopathic thrombocytopenic purpura complicating pregnancy. Blood Rev. 2002 Mar;16(1):43-6.

  11. Tanaka M, Balki M, McLeod A, Carvalho JC. Regional anesthesia and nonpreeclamptic thrombocytopenia: time to re-think the safe platelet count. Rev Bras Anestesiol. 2009 Mar-Apr;59(2):142-53.

  12. Anteby E, Shalev O. Clinical relevance of gestational thrombocytopenia of < 100,000/microliters. Am J Hematol 1994 Oct;47(2):118-22.

  13. Subirá M. Trombocitopenia y gestación. Haematologica. 2006;91(Supl 1):195.

  14. Cines DB, Blanchette VS. Immune thrombocytopenic purpura. N Engl J Med. 2002 Mar;346(13):995-1008.

  15. Stasi R, Cooper N, Del Poeta G,Stipa E, Laura Evangelista M, Abruzzese E, Amadori S. Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab. Blood. 2008 Aug 15;112(4):1147-50.

  16. Stavrou E, McCrae KR. Immune thrombocytopenia in pregnancy. Hematol Oncol Clin North Am. 2009 Dec;23(6):1299-316.

  17. Webert KE, Mittal R, Sigouin C, Heddle NM, Kelton JG. A retrospective 11-year analysis of obstetric patients with idiopathic thrombocytopenic purpura. Blood. 2003 Dec;102(13):4306-11.

  18. Burrows RF, Kelton JG. Pregnancy in patients with idiopathic thrombocytopenic purpura: assessing the risks for the infant at delivery. Obstet Gynecol Surv. 1993 Dec;48(12):781-8.

  19. Provan D, Stasi R, Newland AC, Blanchette V, Bolton-Maggs P, Bussel J et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-186. doi:10.1182/blood-2009- 06-225565

  20. Gill KK, Kelton JG. Management of idiopathic thrombocytopenic purpura in pregnancy. Semin Hematol. 2000 Jul;37(3):275-89.

  21. Gisbert JP. Safety of immunomodulators and biologics for the treatment of inflammatory bowel disease during pregnancy and breast-feeding. Inflammatory. Bowel Disease. 2010 May;16(5):881-95.

  22. Cromwell C, Tarantino M, Aledort LM. Safety of anti-D during pregnancy. Am J Hematol. 2009 Apr;84(4):261-2. doi:10.1002/ajh.21376

  23. Michel M, Novoa MV, Bussel JB. Intravenous anti-D as a treatment for immune thrombocytopenic purpura (ITP) during pregnancy. Br J Haematol. 2003 Oct;123(1):142-6.

  24. Cooper N. Intravenous immunoglobulin and anti-RhD therapy in the management of immune thrombocytopenia. Hematol Oncol Clin North Am. 2009 Dec;23(6):1317-27.

  25. Price HV, Salaman JR, Laurence KM, Langmaid H. Immunosuppressive drugs and the foetus. Transplantation. 1976 Apr;21(4):294-8.

  26. Reddy D, Murphy SJ, Kane SV, Present DH, Kornbluth AA. Relapses of inflammatory bowel disease during pregnancy: in-hospital management and birth outcomes. Am J Gastroenterol. 2008 May; 103(5):1203-9. Epub 2008 Apr 16.

  27. Chakravarty E, Murray E, Kelman A, Farmer P. Pregnancy outcomes following maternal exposure to rituximab. Blood. 2011 Feb 3;117(5):1499-506.

  28. Gall B, Yee A, Berry B, Birchman D, Hayashi A, DansereauJ, Hart J. Rituximab for management of refractory pregnancy-associated immune thrombocytopenic purpura. J Obst Gynaecol C. 2010 Dec;32(12):1167-71.

  29. Schmid J, Piroth D, Buhrlen M, Maass N, Brummendorf TH. Galm O. Successful rituximab treatment of refractory immune thrombocytopenia during pregnancy. Onkologie. 2011;34(6):240.

  30. Klink DT, van Elburg RM, Schreurs MW, van Well GT. Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development. Clin Dev Immunol. 2008;2008:271363.

  31. Chouhan JD, Herrington JD. Treatment options for chronic refractory idiopathic thrombocytopenic purpura in adults: focus on romiplostim and eltrombopag. Pharmacotherapy. 2010 Jul;30(7):666-83.

  32. Peitsidis P, Kadir RA. Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum. Expert Opin on Pharmacother. 2011 Mar;12(4):503-16.

  33. Johnson JR, Samuels P. Review of autoimmune thrombocytopenia: pathogenesis, diagnosis, and management in pregnancy. Clin Obstet Gynecol. 1999 Jun;42(2):317-26.

  34. Levy JA, Murphy LD. Thrombocytopenia in Pregnancy. J Am Board Fam Pract.2002 Jul-Aug;15(4):290-7.

  35. Douglas MJ. The Use of Neuraxial Anesthesia in Parturients with Thrombocytopenia: What Is an Adequate Platelet Count? In: Halpern SH, Douglas MJ (Eds.) Evidence-Based Obstetric Anesthesia. Massachussetts: Blackwell; 2005. p. 165-77.

  36. British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Haematol. 2003 Feb;120(4):574-96.

  37. Jensen JF, Wiedmeier SE, Henry E, Silver RM, Christensen RD. Linking maternal platelet counts with neonatal platelet counts and outcomes using the data repositories of a multihospital health care system. Am J Perinatol. 2011 Sep;28(8):597-604.

  38. Fujimura K, Harada Y, Fujimoto T, Kuramoto A, Ikeda Y, Akatsuka J, Dan K, Omine M, Mizoguchi H. Nationwide study of idiopathic thrombocytopenic purpura in pregnant women and the clinical influence on neonates. Int J Hematol. 2002 May;75(4):426-33.

  39. Adams DM, Bussel JB, Druzin ML. Accurate intrapartum estimation of fetal platelet count by fetal scalp samples smear. Am J Perinatol. 1994 Jan;11(1):42-5.

  40. Nurden P, Nurden AT. Congenital disorders associated with platelet dysfunctions. Thromb Haemost. 2008 Feb;99(2):253-63.

  41. Ishii A, Honnma T, Ishida M, Sano F, Hamada H, Takayanagi M. Pregnancy complicated by the May-Hegglin anomaly. J Perinat Med.1993;21(3):247-52.

  42. Peitsidis P, Datta T, Pafilis I, Otomewo O, Tuddenham EG, Kadir RA. Bernard Soulier syndrome in pregnancy: a systematic review. Haemophilia.2010 Jul;16(4):584-91.




2020     |     www.medigraphic.com