Gestational (incidental) thrombocytopenia is a condition that generally affects pregnant women. Thrombocytopenia is defined as a decrease in platelet count from the normal range of 150,000 -400,000/? L to a count lower than 150,000/? L. There is still ongoing research to determine the reason for the decline in platelet counts in women with normal pregnancies. Some researchers speculate the cause must depend on dilution, decreased platelet production, or increased incidence of change. Although women with normal pregnancies experience low platelet counts, women who experience a steady decline in platelets will be diagnosed with thrombocytopenia and women with levels greater than 70,000/? L will be diagnosed with pregnancy thrombocytopenia.
Thrombocytopenia affects about 7-10% of pregnant women and 7-10%, in that population; about 70-80% have pregnancy thrombocytopenia
Gestational thrombocytopenia is a disorder similar to immune thrombocytopenia (ITP) and it is difficult to distinguish between the two disorders. Therefore, medical history is performed because diagnostic tests are not available.
Video Gestational thrombocytopenia
Mekanisme
Generally, there is a decrease in platelet counts in pregnant women and it will be for various reasons. The two main causes of thrombocytopenia are a decrease in platelet production in the bone marrow and an increase in platelet damage. Platelets, along with other components of the blood, are produced in spongy tissue found in bone, known as bone marrow. A low platelet count may be due to a decline in platelet production in the bone marrow. Decrease in production will be caused by vitamin B12 deficiency, iron deficiency, aplastic anemia, viral infections, chemotherapy, alcohol consumption, leukemia, myelodysplasia, and cirrhosis. During pregnancy, the fetal waste product spreads into the mother's sinus (bloodstream), and causes the mother's spleen to become overactive and enlarged. Usually, filter the spleen and remove waste products and with undesirable excess substances in the bloodstream, the spleen will remove blood cells too quickly or store platelets. In both cases, the overactive spleen will cause a decrease in platelet circulation.
Maps Gestational thrombocytopenia
Symptoms
Although there are no alarming symptoms associated with pregnancy thrombocytopenia, an individual with thrombocytopenia may exhibit the following symptoms -
- Nose bleed
- Gum bleeding
- Blood in urine/stool
- Easy bruising
- Spleen enlargement
- Jaundice
- Continual bleeding due to cutting
- Severe menstrual flow
- Rashes (petechiae), especially on the lower leg
Diagnosis
Pregnancy thrombocytopenia will become apparent during the second trimester of the second through the third trimester of pregnancy and diagnosed by exclusion. For example, women with a history of immune thrombocytopenia or thrombocytopenia, before pregnancy, will not be diagnosed with pregnancy thrombocytopenia.
Patients with low platelet counts, lower than 70,000/? L, will be difficult to diagnose. The reason is that low platelet counts may be due to gestational thrombocytopenia or immune thrombocytopenia. In such cases, treatment of immune thrombocytopenia therapy (corticosteroids, or intravenous immunoglobulin) will be instructed. If there is an increase in platelet level, the patient will be diagnosed with immune thrombocytopenia, and otherwise the patient will be diagnosed with severe pregnancy thrombocytopenia.
In order for the doctor to determine the underlying cause of pregnancy thrombocytopenia, the following test is performed -
Blood Test
During a routine prenatal examination, the doctor will perform a complete blood count test to determine the blood component. A full blood count will provide more information about joint platelet levels.
Doctors can perform blood tests for platelet antibodies, which may be produced as a result of certain drugs, such as quinine. Doctors can also perform blood coagulation tests by adding chemicals to the blood to determine how long it takes blood to freeze.
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The doctor may perform ultrasound around the spleen to determine if the spleen is enlarged by an overactive spleen. The ultrasound will give a picture of the spleen and the doctor will compare it to a normal-sized spleen.
Marrow Bone Marrow and/or Biopsy
Doctors may aspirate bone marrow and/or bone marrow biopsy, if they suspect a decrease in platelet production in the bone marrow. Bone marrow aspiration and bone marrow biopsy can be performed at the same time.
Causes & amp; prevention
Cause
It is clear that there is a decrease in platelet count during pregnancy, but the cause of the decline is unknown. But the researchers theorized that the decline in platelet counts was caused by decreased platelet production and/or increased platelet destruction.
Prevention
No information is known about the prevention of this disorder.
No information is known about a group of women who may be diagnosed with this disorder.
Treatment and Prognosis
Treatment
Women, diagnosed with pregnancy thrombocytopenia, will undergo a full blood test conducted during prenatal visits and monitored by a doctor. After the diagnosis of pregnancy thrombocytopenia, women should continue their normal activities because the diagnosis does not change the management of pregnancy. Also, the diagnosis of pregnancy thrombocytopenia poses no danger or risk to the mother or fetus. No diagnostic tests are available for pregnancy thrombocytopenia; but are diagnosed by exception. Women who have a history of immune thrombocytopenia or thrombocytopenia before pregnancy will not be diagnosed with pregnancy thrombocytopenia
Women who have platelet levels lower than 70,000/? L, during pregnancy, may have severe pregnancy thrombocytopenia or immune thrombocytopenia. In such cases, if treatment of immune thrombocytopenia therapy (corticosteroid, or intravenous immunoglobulin) does not increase platelet count, patients will be diagnosed with severe pregnancy thrombocytopenia. Severe pregnancy thrombocytopenia may present a risk of complications with the use of epidural or general anesthesia during labor.
Prognosis
Those who did not have a history of previous thrombocytopenia, other than the incidence of previous pregnancies (thrombocytopenia of pregnancy), platelet levels will return to the normal range of 1-2 months after delivery. Postpartum, about 1-3 months later, women with pregnancy thrombocytopenia should undergo a complete blood test. Finally, pregnancy thrombocytopenia is a disorder that can occur again in subsequent pregnancies
Research
Roberto Stasi, a researcher at the Department of Hematology at St. Hospital. Georges in London, England brings an excellent point to be able to know the exact diagnosis of the disorder during the stage of pregnancy. This will help doctors treat patients and help patients with pregnancy management.
History
History of this disorder has not been set.
References
Source of the article : Wikipedia
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