关键词: 紫癜,血小板减少性,特发性, 血小板减少, 妊娠并发症, 血小板减少,新生儿同种免疫性, 糖皮质激素类, 免疫球蛋白类

Abstract:

Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease and the most common cause of platelet counts below 50×10⁹/L in early pregnancy. At present, it is believed that the production of anti-platelet autoantibodies, increased platelet destruction mediated by T cells and platelet apoptosis play an important role in the pathogenesis. ITP during pregnancy lacks specific symptoms and signs, the classifications and differential diagnoses are complicated. It is very easy to be confused with gestational thrombocytopenia, so it is the most necessary to differentiate with it in the clinical practice. ITP during pregnancy lacks standardized diagnostic practice, but the principle should be to emphasize the importance of pre-pregnancy consultation, to strike a perfect balance between the risks of continuing the pregnancy and preventive prenatal intervention, to pay attention to the maternal platelet changes and clinical manifestations, to raise the platelet count to a safe rather than normal range, and to avoid overtreatments. Treatment options include emergency treatment, first-line treatment, and second-line treatment. In patients with clinical bleeding,such as unmanageable active bleeding and spontaneous bleeding of vital organs,and in perioperative period, the platelet count should be increased to above 50×10⁹/L as soon as possible; first-line treatments include prednisone acetate and intravenous immunoglobulin, which can be used alone or in combinations, second-line treatments are limited during pregnancy.

Key words: Purpura,thrombocytopenic,idiopathic, Thrombocytopenia, Pregnancy complications, Thrombocytopenia,neonatal alloimmune, Glucocorticoids, Immunoglobulins