Statistical analyses-Analysis of variance and two tailed Student's t test were used after log transformation to make the data distribution normal.
IntroductionPregnancy is accompanied by profound changes in maternal haemodynamics. Plasma volume expands considerably, but changes in the peripheral vascular tone usually prevent an increase in blood pressure. The precise regulation of such changes has not been documented.Calcitonin gene related peptide is a potent vasoactive peptidel-' that normally circulates in man,4 but its physiological role is not fully understood. To determine the gestational changes in its secretion we measured plasma concentrations of immunoreactive calcitonin gene related peptide on four occasions during entirely normal pregnancies and at five to seven days post partum in a cross sectional study. Such studies have not to our knowledge been undertaken.
Thrombocytopenia is common in pregnancy and is diverse in etiology. Immune thrombocytopenic purpura (ITP) may affect both mother and the newborn. Gestational (incidental) thrombocytopenia in an otherwise fit woman, at term is the most frequent type of thrombocytopenia and poses no clinical consequences for mother or infant. We report six women who presented with severe thrombocytopenia during pregnancy. Five were treated in late pregnancy, either with intravenous immunoglobulin (IVIg), or IVIg followed by steroids. There was no response, and four received a platelet transfusion during delivery. The platelet counts in all the infants were normal and the maternal thrombocytopenia resolved spontaneously after delivery in all cases. Our observations suggest that this is a group of patients with a severe form of gestational thrombocytopenia. The severe form of gestational thrombocytopenia appears to be rare, and recognition is important, as it may recur in subsequent pregnancies and does not require any therapeutic intervention.
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