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Titolo:
SUCCESSFUL EMERGENCY SPLENECTOMY DURING PREGNANCY IN A PATIENT WITH LIFE-THREATENING IDIOPATHIC THROMBOCYTOPENIA - CASE-REPORT
Autore:
STIEMER B; OPRI F; SENGER D; KREUSER ED; BERDEL W; HOPP H; SANFT K; BAUER K; WEITZEL HK;
Indirizzi:
FREE UNIV BERLIN,KLINIKUM BENJAMIN FRANKLIN,DEPT OBSTET & GYNECOL,HINDENBURGDAMM 30 D-12200 BERLIN GERMANY FREE UNIV BERLIN,KLINIKUM BENJAMIN FRANKLIN,DEPT OBSTET & GYNECOL D-12200 BERLIN GERMANY FREE UNIV BERLIN,KLINIKUM BENJAMIN FRANKLIN,DEPT HEMATOL & ONCOL D-12200 BERLIN GERMANY FREE UNIV BERLIN,KLINIKUM BENJAMIN FRANKLIN,DEPT ANESTHESIA D-12200 BERLIN GERMANY
Titolo Testata:
Journal of perinatal medicine
fascicolo: 6, volume: 24, anno: 1996,
pagine: 703 - 706
SICI:
0300-5577(1996)24:6<703:SESDPI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNE THROMBOCYTOPENIA; MANAGEMENT; PURPURA;
Keywords:
IDIOPATHIC THROMBOCYTOPENIA; NEONATAL OUTCOME; PREGNANCY; PULMONARY BLEEDING; SPLENECTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
7
Recensione:
Indirizzi per estratti:
Citazione:
B. Stiemer et al., "SUCCESSFUL EMERGENCY SPLENECTOMY DURING PREGNANCY IN A PATIENT WITH LIFE-THREATENING IDIOPATHIC THROMBOCYTOPENIA - CASE-REPORT", Journal of perinatal medicine, 24(6), 1996, pp. 703-706

Abstract

Thrombocytopenia can be a pathophysiological feature of pregnancy. Inthe case reported, the thrombocyte count was reduced to 1% of normal (1 x 10(9) thrombocytes/l) at 28 weeks of gestation. In chronological order, the patient showed epistaxis, macrohematuria and gingival, conjunctival, intracerebral and pulmonary bleeding. The latter was life-threatening. An emergency splenectomy was undertaken, without complications. The operation was followed by a massive increase in the thrombocyte count, reaching 200 X 10(9)/l four days later. Unfortunately, a premature rupture of the membranes, with signs of amnion infection, occurred on the seventh day. A Cesarean section was undertaken (30 weeks ofgestation), without complications. Both mother and baby are in good health 10 months later. The newborn had a normal thrombocyte count at delivery and thereafter. The life-threatening hemorrhage of the mother,the delivery of an uneffected baby and the relatively quick remissionafter splenectomy suggest an upregulated destruction of thrombocytes by the maternal spleen. The increased level of Macrophage-Colony Stimulating Factor (M-CSF), a normal feature of pregnancy, has the potential to augment thrombocyte destruction by activating macrophages. The production of anti-thrombocyte antibodies, especially if localized in the spleen, could result in increased thrombocyte sequestration by macrophages with severe effects focused on the mother.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 09:25:40