Coagulation Defects

Thrombocytopenia in pregnancy

“…Heparin is advocated in cases where the vascular tree is intact, such as amniotic fluid embolism and the chronic DIC accompanying retention of a dead fetus.8' Heparin is also important in the prevention of gangrene in the rare and serious post-partum complication of Gram-negative septicaemia and DIC, purpura fulminans. 82 DIC and thrombocytopenia are also features of acute fatty liver of pregnancy. The maternal and fetal mortality (both around 80%) in this rare syndrome appear reduced by prompt delivery, and so recognition of impending hepatic and renal failure in the third trimester is vital.268' Heparin In 0.6-9% of patients, heparin induces antiplatelet IgG, which can cause thrombocytopenia and thrombosis, often arterial, due to complementmediated platelet activation.84'85 This action is heparin-dependent, and as heparin does not cross the placenta, the fetus is not affected.…”

Manajemen Anestesi Pada Kehamilan Sistemik Lupus Eritematosus

“…Penelitian yang dilakukan Garenstein dkk menemukan bahwa risiko eksaserbasi 3 kali lebih besar pada 20 minggu pertama kehamilan dan 6 kali lebih besar pada 8 minggu pertama postpartum dibanding dengan masa 32 minggu sebelum konsepsi. 7,8,9,10 Teknik anastesi regional merupakan teknik farmakologis yang sangat populer dan menjadi standar emas karena memberikan analgesia yang optimal selama proses persalinan dengan efek samping minimal terhadap ibu dan fetus bila dibandingkan dengan pemberian analgesia sistemik atau inhalasi. Adapun teknik anastesi epidural dapat memberi hasil lebih baik dibandingkan dengan metode penghilang nyeri lainnya pada persalinan normal.…”

Idiopathic thrombocytopenic purpura in pregnancy; A randomized trial on the effect of antenatal low dose corticosteroids on neonatal platelet count

“…The worsening thrombocytopenia is more likely due to the development of the neonatal splenic circulation and the more efficient removal of antibody coated platelets (Letzky 1989). I would agree with the reply of Christiaens et al .…”