Quantitative and qualitative platelet abnormalities during pregnancy

How, HY; Bergmann, F.; Koshy, Mabel; Chediak, J; Presperin, Celeste; Gall, SA

doi:10.1016/0020-7292(91)90492-n

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“…Therefore, a medical history, physical examination and laboratory testing may be inadequate in detecting these haemostasis disorders if they are performed too early. 10 In addition, no relationship between mild coagulation abnormalities during pregnancy and haemorrhagic complications during extradural analgesia 11 or delivery 12 have yet been established.…”

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confidence: 99%

Pre-anaesthetic assessment of coagulation abnormalities in obstetric patients: usefulness, timing and clinical implications

Simon

Santi

Sacquin

et al. 1997

British Journal of Anaesthesia

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The usefulness and optimal timing of laboratory coagulation tests before obstetric extradural analgesia are controversial. Moreover, the significance of mild coagulation abnormalities during pregnancy remains unclear. We have assessed the reliability of coagulation tests performed several weeks before delivery as predictors of coagulation abnormalities during labour. Platelet count, plasma fibrinogen concentration, prothrombin time (PT) and activated partial thromboplastin time (aPTT) were sampled in 797 women during the ninth month of pregnancy and checked during labour. Platelet count was less than 100 x 10(9) litre-1 for 11 women during labour. Only three had been detected by the first sample. Platelet count less than 100 x 10(9) litre-1 or fibrinogen concentration less than 2.9 g litre-1 during labour were associated with an increase in the incidence of postpartum haemorrhage (odds ratio = 19.7). We conclude that a platelet count several weeks before delivery was not reliable in predicting thrombocytopenia during labour and that women with mild coagulation abnormalities in early labour may need special attention regarding the risk of postpartum haemorrhage.

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confidence: 99%

Pre-anaesthetic assessment of coagulation abnormalities in obstetric patients: usefulness, timing and clinical implications

Simon

Santi

Sacquin

et al. 1997

British Journal of Anaesthesia

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“…Specific autoantibodies are considered to be the hallmark of autoimmunity. Women with AITP cannot be distinguished from those with gestational thrombocytopenia using one or more of the prototypic platelet antiglobulin tests currently available (platelet‐associated IgG, platelet‐associated C3, platelet‐associated IgM or platelet‐bindable IgG, M and C3 in plasma) (Kaplan et al , 1990; How et al , 1991). In contrast, specific antibodies detected by antigen capture assays (including monoclonal antibody immobilization of platelet antigens or MAIPA) were rarely detected in women with gestational thrombocytopenia (Lescale et al , 1996).…”

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confidence: 99%

Pregnancy‐associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype

Gandemer¹,

Kaplan

Quelvennec

et al. 1999

Br J Haematol

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Summary. In a prospective study between 1993 and 1998, data was collected from 46 pregnant women and subsequently from their babies. 25 pregnant women with active autoimmune thrombocytopenic purpura (AITP) or a history of AITP (group A) and 21 pregnant women with isolated thrombocytopenia and identification of specific platelet autoantibodies detected by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay (group B) were evaluated for platelet-associated immunoglobulin-G (PAIgG), MAIPA assay and HLA genotype. Neonatal platelet counts were performed at least three times in the first week. 11 neonates were thrombocytopenic (23·9%). No severe haemorrhage occurred. There were no significant differences regarding the values of PAIgG or positive MAIPA tests between mothers of thrombocytopenic or healthy newborns. A significant difference, however, regarding the HLA DRB3* allele was found, with a high incidence in the subgroup of mothers of healthy newborns (P ¼ 0·005). A similar trend was found among mothers with anti-GPIIbIIIa antibodies (P ¼ 0·06). In contrast, HLA DRB5* allele appeared to be present especially in mothers of thrombocytopenic newborns (not significant). Our data suggest that mothers with AITP who have the HLA DRB3* genotype are unlikely to give birth to a thrombocytopenic baby. This study provides a preliminary report on a noninvasive test to identify infants who are likely to be affected.

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Quantitative and qualitative platelet abnormalities during pregnancy

Cited by 2 publications

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Pre-anaesthetic assessment of coagulation abnormalities in obstetric patients: usefulness, timing and clinical implications

Pre-anaesthetic assessment of coagulation abnormalities in obstetric patients: usefulness, timing and clinical implications

Pregnancy‐associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype

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