妊娠期血小板减少症围产期管理的现代方法

О.М. Naumchik, I. Davydova, A. Limanska
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引用次数: 0

摘要

孕妇血液系统最常见的疾病是贫血和血小板减少症(TP)。妊娠期间血小板数量有显著减少的普遍趋势,从妊娠早期开始,分娩时血小板数量最少。目的:了解妊娠期血小板减少症的运动特点,为妊娠期血小板减少症的诊断和治疗提供参考。妊娠期TP的病因有三组情况——TP在妊娠期外的特征性情况和与妊娠相关的情况:妊娠血小板减少症(GTP)、妊娠特异性并发症、以TP为特征的疾病表现,其中主要原因是免疫性血小板减少症(ITP)。妊娠期TP最常见的病因是GTP,与ITP一样,GTP是排除性诊断,需要鉴别诊断。妊娠期治疗TP的目的是达到每个妊娠期不同的安全血小板计数,而不是目标值。如果对ITP的治疗是必要的,则持续应用具有疗效控制的治疗方法。中重度TP孕妇是围产期高危人群,需要仔细鉴别诊断TP的病因,计算母胎风险,选择该类妊娠的策略、分娩方式和时间,制定产后护理计划。作者未声明存在利益冲突。关键词:妊娠,血小板减少,免疫性血小板减少,妊娠期血小板减少
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Modern approaches for perinatal management in thrombocytopenia during pregnancy
The most common diseases of the blood system in pregnant women are anemia and thrombocytopenia (TP). There is a general tendency to significantly reducing of the number of platelets during pregnancy, starting from the first trimester with a minimum number of them during childbirth. Purpose — to learn the features of motion of pregnancy, diagnostic and curative tactician at the thrombocytopenia during pregnancy. The causes of TP during pregnancy are three groups of conditions — conditions for which TP is characteristic outside of pregnancy and conditions associated with pregnancy: gestational thrombocytopenia (GTP), pregnancy-specific complications, manifestations of diseases characterized by TP, with the chief reason among them — immune thrombocytopenia (ITP). The most common cause of TP during pregnancy is GTP, which, like ITP, is diagnose of exclusion that require differential diagnosis. The goal of treating TP during pregnancy is to achieve a safe platelet count that is different for each trimester, not target values. If the treatment of ITP is need lines of therapy with control of efficiency are consistently applied. Pregnant women with moderate and severe TP are a group of high perinatal risk, requiring careful differential diagnosis of the causes of TP, calculation of maternal and fetal risks, choice of tactics of such pregnancy, method and time of delivery, formation of postnatal care plan. No conflict of interest was declared by the authors. Key words: pregnancy, thrombocytopenia, immune thrombocytopenia, gestational thromocytopenia.
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