5,057 results match your criteria Thrombocytopenia in Pregnancy


Non-primary CMV infection not always innocent. A case-report and literature review.

Acta Clin Belg 2020 Jun 3:1-5. Epub 2020 Jun 3.

Department of Neonatology, Antwerp University Hospital, University of Antwerp , Belgium.

Objectives: Cytomegalovirus (CMV) is the most common infectious cause of congenital malformations. CMV infections are frequently symptomatic in case of a primary infection during pregnancy. Generally, maternal immunity protects the newborn against a symptomatic course of the CMV infection. Read More

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http://dx.doi.org/10.1080/17843286.2020.1773651DOI Listing

Preeclampsia-like syndrome induced by severe COVID-19: a prospective observational study.

BJOG 2020 Jun 1. Epub 2020 Jun 1.

Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

Objectives: To investigate the incidence of clinical, ultrasonographic and biochemical findings related to preeclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19.

Design: A prospective, observational study.

Setting: Tertiary referral hospital. Read More

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http://dx.doi.org/10.1111/1471-0528.16339DOI Listing

Severe HELLP syndrome masquerading as thrombocytopenic thrombotic purpura: a case report.

BMC Nephrol 2020 May 29;21(1):204. Epub 2020 May 29.

Department of Nephrology, CHU Tenon, Assistance Publique-Hopitaux de Paris, Paris, France.

Background: Thrombotic microangiopathies (TMAs) occurring in the postpartum period may be difficult to manage. They present as the combination of mechanical hemolytic anemia and consumption thrombocytopenia due to endothelial dysfunction. The cause of this endothelial aggression can be multiple: thrombocytopenic thrombotic purpura (TTP), HELLP syndrome, antiphospholipid syndrome, atypical hemolytic and uremic syndrome or acute fatty liver of pregnancy. Read More

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http://dx.doi.org/10.1186/s12882-020-01865-yDOI Listing

Immune Thrombocytopenia during Pregnancy due to COVID-19.

Am J Hematol 2020 May 23. Epub 2020 May 23.

Department of Clinical Hematology, Amsterdam University Medical Center, Amsterdam, the Netherlands.

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http://dx.doi.org/10.1002/ajh.25877DOI Listing

Clinical course of Coronavirus Disease-2019 (COVID-19) in pregnancy.

Acta Obstet Gynecol Scand 2020 May 22. Epub 2020 May 22.

Department of Obstetrics and Gynecology, University Hospital Puerta de Hierro Majadahonda, Autonoma University of Madrid, Madrid, Spain.

Introduction: The aim of this study is to report our clinical experience in the management of pregnant women infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the first thirty days of the Coronavirus disease (COVID-19) pandemic.

Material And Methods: We reviewed clinical data from the first 60 pregnant women with COVID-19 whose care was managed at Puerta de Hierro University Hospital, Madrid, Spain from March 14 to April 14 , 2020. Demographic data, clinical findings, laboratory test results, imaging findings, treatment received, and outcomes were collected. Read More

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http://dx.doi.org/10.1111/aogs.13921DOI Listing

HELLP Syndrome or Acute Fatty Liver of Pregnancy: A Differential Diagnostic Challenge: Common Features and Differences.

Geburtshilfe Frauenheilkd 2020 May 18;80(5):499-507. Epub 2020 May 18.

Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany.

HELLP syndrome and the less common acute fatty liver of pregnancy (AFL) are unpredictable, life-threatening complications of pregnancy. The similarities in their clinical and laboratory presentations are often challenging for the obstetrician when making a differential diagnosis. Both diseases are characterised by microvesicular steatosis of varying degrees of severity. Read More

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http://dx.doi.org/10.1055/a-1091-8630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234826PMC

Romiplostim for management of refractory immune thrombocytopenic purpura in the immediate postpartum period.

BMJ Case Rep 2020 May 18;13(5). Epub 2020 May 18.

Department of OB/GYN, Trinity Health of New England, Hartford, Connecticut, USA

We present a case of a pregnant woman with chronic immune thrombocytopenic purpura and chronic hypertension who developed pre-eclampsia with severe features warranting delivery. Her overall clinical picture and liver enzymes improved in the immediate postpartum period, however, aggressively progressing thrombocytopenia posed a diagnostic dilemma to the interdisciplinary care team. After failing to respond to first-line therapies including high-dose corticosteroids and intravenous immunoglobulin, she was successfully managed with a trial of the thrombopoietin receptor agonist, Romiplostim. Read More

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http://dx.doi.org/10.1136/bcr-2020-234335DOI Listing

Thrombotic microangiopathy and pregnancy.

Ceska Gynekol 2020 ;85(1):18-28

Objective: The aim of this study is to draw attention to a nosological unit called thrombotic microangiopathy (TMA). This syndrome represents a serious pathological condition characterized by microangiopathic haemolytic anemia (MAHA), thrombocytopenia and various organ dysfunction. Patients are most often presented with symptoms of the HELLP syndrome but if the clinical picture is not restituted within 48-72 hours after delivery, other TMAs should be considered. Read More

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January 2020

Comparative Study of the Clinical Application of 2 Bleeding Grading Systems for Pregnant Women With Immune Thrombocytopenia.

Clin Appl Thromb Hemost 2020 Jan-Dec;26:1076029620910790

Department of Haematology, Fujian Institute of Haematology, Fujian Provincial Key Laboratory on Haematology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.

To compare the clinical practicability of two bleeding grading systems (BGS) in pregnancy with Immune Thrombocytopenia (ITP). The clinical data of 154 cases were retrospectively analyzed with the 2016 version of the ITP Bleeding Scale (ITP-2016) and the ITP-specific bleeding assessment tool (ITP-BAT). The correlation between the two BGS and the relations among the platelet counts, gestational ages, and disease stages were respectively analyzed. Read More

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http://dx.doi.org/10.1177/1076029620910790DOI Listing

Congenital Syphilis Presenting with Prenatal Bowel Hyperechogenicity and Necrotizing.

Sisli Etfal Hastan Tip Bul 2020 25;54(1):113-116. Epub 2020 Mar 25.

Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Congenital syphilis is a severe disease that arises from the vertical transmission of Treponema pallidum. Clinical findings are related to the pregnancy stage, fetal gestational week, maternal treatment and fetal immunologic response. Prematurity, low birth weight, nonimmune hydrops fetalis, necrotizing enterecolitis, hepatomegaly, skin eruptions, thrombocytopenia, hemolytic anemia and fever can be detected in the symptomatic newborn. Read More

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http://dx.doi.org/10.14744/SEMB.2018.22605DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192246PMC

Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss.

Cochrane Database Syst Rev 2020 05 2;5:CD012852. Epub 2020 May 2.

Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.

Background: Aspirin and heparin are widely used as preventive strategy to reduce the high risk of recurrent pregnancy loss in women with antiphospholipid antibodies (aPL). This review supersedes a previous, out-of-date review that evaluated all potential therapies for preventing recurrent pregnancy loss in women with aPL. The current review focusses on a narrower scope because current clinical practice is restricted to using aspirin or heparins, or both for women with aPL in an attempt to reduce pregnancy complications. Read More

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http://dx.doi.org/10.1002/14651858.CD012852.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195627PMC

Thrombotic thrombocytopenic purpura with Graves' disease during pregnancy.

Proc (Bayl Univ Med Cent) 2020 Apr 23;33(2):270-272. Epub 2020 Jan 23.

Department of Pathology, Baylor University Medical CenterDallasTexas.

Thrombotic thrombocytopenic purpura may be seen with several autoimmune disorders such as immune thrombocytopenia purpura, immune hemolytic anemia, and systemic lupus erythematosus, but it is rarely associated with Graves' disease. We report a patient with thrombotic thrombocytopenic purpura associated with Graves' disease. Read More

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http://dx.doi.org/10.1080/08998280.2020.1713029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155955PMC

Antiphospholipid syndrome presenting as treatment resistant bipolar disorder and thrombocytopenia in a young male.

J Neuroimmunol 2020 Jun 11;343:577238. Epub 2020 Apr 11.

Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Antiphospholipid syndrome (APS), an autoantibody mediated disease, is characterized by presence of antibodies against the proteins bound to the phospholipid membranes. The antibodies are predominantly formed against beta-2-glycoprotein I (b2GPI) which is considered pathogenic, but presence of lupus anticoagulant is a predictor of thrombotic events. The thrombotic events in APS may manifest as venous or arterial or small vessel thrombosis in any tissue or organ and pregnancy related complications namely, recurrent (three or more) and early spontaneous miscarriages before 10 weeks of gestation or unexplained deaths of normal fetus at or beyond 10 weeks, eclampsia or severe pre-eclampsia, intra-uterine growth retardation and pre-term births. Read More

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http://dx.doi.org/10.1016/j.jneuroim.2020.577238DOI Listing

Apixaban therapy in a pregnant woman with heparin-induced thrombocytopenia and venous thromboembolic events caused by congenital antithrombin deficiency: A case report.

Case Rep Womens Health 2020 Jul 3;27:e00200. Epub 2020 Apr 3.

Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan.

We report the case of a 35-year-old pregnant woman (gravida 3, para 1) with antithrombin deficiency who was successfully treated with apixaban. She had a history of heparin-induced thrombocytopenia and venous thromboembolic events. Pregnancy was confirmed while the patient was having anticoagulant therapy for a persistent thrombus. Read More

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http://dx.doi.org/10.1016/j.crwh.2020.e00200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152699PMC

The prevalence of HPA-1a alloimmunization and the potential risk of FNAIT depend on both the DRB3*01:01 allele and associated DR-DQ haplotypes.

Scand J Immunol 2020 Apr 16:e12890. Epub 2020 Apr 16.

Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.

Alloimmunization against human platelet antigen (HPA)-1a during pregnancy can cause foetal/neonatal alloimmune thrombocytopenia (FNAIT) and severe bleeding in the foetus or newborn and likely depends on several factors. HPA-1a alloimmunization is associated with DRB3*01:01, which is associated with several DR-DQ haplotypes. However, it is not known to what extent these haplotypes contribute to the prevalence of HPA-1a alloimmunization. Read More

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http://dx.doi.org/10.1111/sji.12890DOI Listing

Lupus-Induced Vasculitis and Multiple Organ Dysfunction Syndrome as the First Presentation of Systemic Lupus Erythematosus (SLE) in Pregnancy.

Am J Case Rep 2020 Apr 14;21:e921299. Epub 2020 Apr 14.

Department of Rheumatology, Henry Ford Hospital/Wayne State University, Detroit, MI, USA.

BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production leading to inflammation in multiple organs; it commonly affects young women in their child-bearing years. Clinical manifestations are diverse and range from mild arthritis to diffuse alveolar hemorrhage (DAH). DAH is a rare and devastating complication of SLE that carries a mortality rate of up to 50%, despite aggressive therapy. Read More

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http://dx.doi.org/10.12659/AJCR.921299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176590PMC

What's new in obstetric anesthesia in 2018?

Authors:
C F Weiniger

Int J Obstet Anesth 2020 May 19;42:99-108. Epub 2020 Mar 19.

Division of Anesthesia, Critical Care and Pain, Tel Aviv Sourasky Medical Center, Israel. Electronic address:

The Gerard W. Ostheimer Lecture presented at the annual meeting of the Society of Obstetric Anesthesia and Perinatology (SOAP) is a one-year summary of the literature published in domains of interest to anesthesiologists who manage and care for obstetric patients. One individual is asked to review the literature and present the lecture. Read More

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http://dx.doi.org/10.1016/j.ijoa.2020.03.002DOI Listing

Thrombocytopenia in Pregnancy: Approach to Diagnosis and Management.

Semin Thromb Hemost 2020 Apr 7;46(3):256-263. Epub 2020 Apr 7.

Division of Hematology/Oncology, Department of Medicine, Mass General Cancer Center, Massachusetts General Hospital, Boston, Massachusetts.

The impact of thrombocytopenia varies widely depending on the underlying pathophysiology driving it. The biggest challenge in managing thrombocytopenia in pregnancy is accurately identifying the responsible pathophysiology-a task made difficult given the tremendous overlap in clinical and laboratory abnormalities associated with different thrombocytopenia processes. The most common etiologies of thrombocytopenia in pregnancy range from physiology deemed benign to those that are life-threatening to the mother and fetus. Read More

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http://dx.doi.org/10.1055/s-0040-1708842DOI Listing

Effect of Maternal Preeclampsia on Hematological Profile of Newborns in Qatar.

Biomed Res Int 2020 12;2020:7953289. Epub 2020 Mar 12.

Corporate Communication Department, Hamad Medical Corporation (HMC), P.O. Box 3050, Doha, Qatar.

Background: Preeclampsia is a major cause of pregnancy-related maternal, fetal, and neonatal morbidities and mortalities. We aimed to review the effect of maternal preeclampsia on the hematological profile of newborns in the Qatari population.

Methods: In this case-control study, we reviewed data and complete blood count results of neonates born to Qatari women diagnosed of preeclampsia in 2017 in comparison with data of a control group. Read More

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http://dx.doi.org/10.1155/2020/7953289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7097766PMC

Antiphospholipid syndrome: a case report with an unusual wide spectrum of clinical manifestations.

Auto Immun Highlights 2019 Dec 19;10(1). Epub 2019 Oct 19.

Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.

Background: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis, and the detection of circulating antiphospholipid antibodies. The classification criteria for definite APS are actually met when at least one clinical criterion (thrombosis or pregnancy morbidity) is present in association of one laboratory criterion (LAC, aCL antibody or aβ2GPI antibody present on two or more occasions, at least 12 weeks a part), and thrombosis should be confirmed by objective validated criteria. The average age of primary APS patients has been reported to be about 35-40 years and the disease is more common in women than in men. Read More

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http://dx.doi.org/10.1186/s13317-019-0119-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065311PMC
December 2019

Upper limb phocomelia: A prenatal case of thrombocytopenia-absent radius (TAR) syndrome illustrating the importance of chromosomal microarray in limb reduction defects.

Taiwan J Obstet Gynecol 2020 Mar;59(2):318-322

Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal; Laboratory of Basic Immunology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.

Objective: To describe the ultrasonographic, pathologic and molecular findings in a fetus with TAR syndrome, and to illustrate the contribution of chromosomal microarray analysis (CMA) to the etiological investigation of fetal upper limb reduction defects.

Case Report: A 35-year-old woman was referred for Genetic Counseling after pregnancy termination for severe upper limb bilateral phocomelia detected in the second trimester. Fetal autopsy showed severe shortening of the arms and forearms. Read More

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http://dx.doi.org/10.1016/j.tjog.2020.01.024DOI Listing

Preeclampsia before fetal viability in women with primary antiphospholipid syndrome- materno-fetal outcomes in a series of 7 cases.

J Reprod Immunol 2020 Apr 22;138:103101. Epub 2020 Feb 22.

Medical University Graz, 8036, Graz, Austria.

Introduction: Preeclampsia complicates about 10-17 % of pregnancies with antiphospholipid syndrome (APS). It is often severe and might occur sometimes at early gestation. The development of preeclampsia before fetal viability is a huge challenge for obstetricians and demands an intensive discussion regarding the therapeutical options. Read More

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http://dx.doi.org/10.1016/j.jri.2020.103101DOI Listing

Are pregnancies with lupus but without APS of good prognosis?

Autoimmun Rev 2020 Apr 27;19(4):102489. Epub 2020 Feb 27.

Univ. Lille, EA 2694: Epidémiologie et qualité des soins, F-59000 Lille, France; Univ Lille, CHU Lille, Pôle Femme Mère Nouveau-né, F-59000 Lille, France.

Background: Pregnancies in women with systemic lupus erythematosus (SLE) are at risk of unfavorable perinatal outcomes, especially when antiphospholipid antibody syndrome (APS) is present. Their prognosis is less clear in other situations.

Objectives: To assess pregnancy prognosis in women with SLE but not APS compared with a control series and determine the poor prognostic factors, if any, detectable before 15 weeks' gestation. Read More

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http://dx.doi.org/10.1016/j.autrev.2020.102489DOI Listing

Potential of Next-Generation Sequencing in Noninvasive Fetal Molecular Blood Group Genotyping.

Transfus Med Hemother 2020 Feb 20;47(1):14-22. Epub 2020 Jan 20.

Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig University, Giessen, Germany.

Hemolytic disease of the fetus and newborn and fetal and neonatal alloimmune thrombocytopenia are caused by maternal antibodies against fetal alloantigens on red blood cells or platelets that are inherited from the father. After transplacental transport to the fetal circulation, antibodies of the IgG class may cause severe fetal anemia or bleeding complications. The indication for noninvasive fetal blood group genotyping is given if a clinically relevant antibody is detected in a pregnant woman and if the father is heterozygous (or unknown) for the implicated blood group allele. Read More

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http://dx.doi.org/10.1159/000505161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036569PMC
February 2020

Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know.

Am J Obstet Gynecol 2020 05 24;222(5):415-426. Epub 2020 Feb 24.

Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.

Coronavirus disease 2019 is an emerging disease with a rapid increase in cases and deaths since its first identification in Wuhan, China, in December 2019. Limited data are available about coronavirus disease 2019 during pregnancy; however, information on illnesses associated with other highly pathogenic coronaviruses (ie, severe acute respiratory syndrome and the Middle East respiratory syndrome) might provide insights into coronavirus disease 2019's effects during pregnancy. Coronaviruses cause illness ranging in severity from the common cold to severe respiratory illness and death. Read More

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http://dx.doi.org/10.1016/j.ajog.2020.02.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093856PMC

Gestational psittacosis: A case report and literature review.

J Obstet Gynaecol Res 2020 May 19;46(5):673-677. Epub 2020 Feb 19.

Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan.

Gestational psittacosis is a rare disease that is associated with significant maternal and fetal morbidity and mortality. Currently, there is no examination method which allows for a quick diagnosis. We report a case of gestational psittacosis that could not be diagnosed as psittacosis during treatment and resulted in maternal and fetal death despite intensive treatment. Read More

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http://dx.doi.org/10.1111/jog.14217DOI Listing

Discordance of cardiovascular abnormalities in a monozygotic twin pair carrying a class II 1q21.1 microdeletion.

Taiwan J Obstet Gynecol 2020 Jan;59(1):123-126

Fetal Medicine Centre, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China. Electronic address:

Objective: We present the prenatal diagnosis of a class II 1q21.1 microdeletion in monozygotic (MZ) twins with discordant phenotypes.

Case Report: A monochorionic diamniotic twin pair presented with discordant ultrasound anomalies; twin A had cardiovascular abnormalities, while twin B did not. Read More

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http://dx.doi.org/10.1016/j.tjog.2019.11.019DOI Listing
January 2020

Transfer of Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome by a Liver Graft From a Pregnant Female Donor to a Male Recipient: A Case Report.

Transplant Proc 2020 Mar 5;52(2):644-646. Epub 2020 Feb 5.

Division of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.

Eclampsia with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a rare complication of pregnancy. HELLP syndrome may occur up to a week postpartum in women with eclampsia. CASE REPORT: We report a case of liver transplantation with the organ procured from a pregnant (gestation week 28) female donor who suffered brain death after cerebellar hemorrhage owing to eclampsia. Read More

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http://dx.doi.org/10.1016/j.transproceed.2019.10.037DOI Listing

Multidrug Therapy for Refractory Immune Thrombocytopenia in Pregnancy.

Obstet Gynecol 2020 Mar;135(3):723-727

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of Pediatric Hematology/Oncology and the Division of Allergy-Immunology, Department of Pediatrics, LAC+USC Medical Center, the Division of Neonatal Medicine, LAC+USC, and the Jane Anne Nohl Division of Hematology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.

Background: Severe immune thrombocytopenia complicating pregnancy may require treatment beyond first-line medications (intravenous immunoglobulins or corticosteroids), but there is a paucity of literature on the use of such second-line agents in pregnancy.

Case: The patient is a 29-year-old woman with early-onset severe immune thrombocytopenia at 13 weeks of gestation. Maternal platelet counts reached a nadir of less than 5×10/L. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003699DOI Listing

Pregnancy outcomes amongst multiple sclerosis females with third trimester natalizumab use.

Mult Scler Relat Disord 2020 May 30;40:101961. Epub 2020 Jan 30.

The Perron Institute for Neurological and Translational Sciences, QE II Medical Centre, Perth, Australia; Faculty of Medicine, University of Western Australia, Perth, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, Australia. Electronic address:

Background: Natalizumab, a monoclonal antibody directed against alpha-4-integrin, is an efficacious treatment used in Multiple Sclerosis (MS). Use in early pregnancy is safe but information in the third trimester is limited. Ceasing natalizumab is often associated with an increased risk in MS relapse and in some instances natalizumab continuation during pregnancy may be required. Read More

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http://dx.doi.org/10.1016/j.msard.2020.101961DOI Listing

[How I treat primary immune thrombocytopenia in pregnancy].

Authors:
L Wang M Hou

Zhonghua Xue Ye Xue Za Zhi 2019 Dec;40(12):977-979

Department of Hematology, Qilu Hospital, Shandong University, Jinan 250012, China.

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http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2019.12.001DOI Listing
December 2019

Fetomaternal Outcome in Women with Pregnancy Induced Hypertension versus Normotensive Pregnancy.

J Nepal Health Res Counc 2020 Jan 21;17(4):495-500. Epub 2020 Jan 21.

Department of Obstetrics and Gynecology, Kathmandu Model Hospital, Nepal.

Background: A hypertensive disorder in pregnancy comprises one of the deadly triad along with hemorrhage and infection-that contributes greatly to maternal morbidity and mortality. The aim of this study was to compare the feto-maternal outcome in pregnancy induced hypertension with normotensive pregnant women.

Methods: A cross sectional prospective study was conducted in Paropakar Maternity and Women's Hospital from 1st February 2018 to 1st May 2018. Read More

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http://dx.doi.org/10.33314/jnhrc.v17i4.2103DOI Listing
January 2020

Maternal antibodies against paternal class I human leukocyte antigens are not associated with foetal and neonatal alloimmune thrombocytopenia.

Br J Haematol 2020 May 29;189(4):751-759. Epub 2020 Jan 29.

Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany.

The causative role of maternal, anti-human leukocyte antigen (anti-HLA) class I antibodies in foetal and neonatal alloimmune thrombocytopenia (FNAIT) remains controversial. Furthermore, in FNAIT cases caused by anti-human platelet antigen-1a (anti-HPA-1a) antibodies, the possible additive effect of maternal anti-HLA class I antibodies on outcomes is unclear. Among 817 mother-father-neonate trios of suspected FNAIT, we assessed the possible association of maternal anti-HLA class I antibodies with neonatal platelet count, and the incidence of FNAIT caused by anti-HPA-1a antibodies. Read More

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http://dx.doi.org/10.1111/bjh.16419DOI Listing

Multiple metal exposure and platelet counts during pregnancy: A repeated measure study.

Environ Int 2020 Mar 25;136:105491. Epub 2020 Jan 25.

Wuhan Medical and Healthcare Center for Women and Children, Wuhan, Hubei, People's Republic of China.

Background: Evidence from animal and in vitro studies suggest that some metals interfere with normal platelet counts (PLT). However, limited human studies have investigated the association of metals and PLT, a marker of hematologic and hemostatic, particularly in susceptible populations such as pregnant women.

Objectives: Our purpose was to investigate the associations of repeated measures of 13 urinary metals with PLT during pregnancy. Read More

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http://dx.doi.org/10.1016/j.envint.2020.105491DOI Listing
March 2020
5.559 Impact Factor

[Program for clinical care of immune thrombocytopenic purpura in pregnancy].

Lakartidningen 2020 01 23;117. Epub 2020 Jan 23.

Clintec, Karolinska Institutet - Obstetrics and Gynecology, Karolinska Sjukhuset Huddinge, Sweden Clintec - Obstetrics and Gynecology Huddinge, Sweden.

A program for care of women with immune thrombocytopenic purpura (ITP) with the recommendation to avoid treatment if platelets were >20 × 109/l during pregnancy, with the target level 100 × 109/l at delivery, was introduced. Treatment should be given with intravenous immunoglobulin (IVIG) or corticosteroids. Out of 75 pregnancies with ITP, 39 percent were treated and the treatment period was shorter with IVIG. Read More

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January 2020

Evans Syndrome and pregnancy: A case report with literature review.

J Pak Med Assoc 2019 Jul;69(7):1047-1048

Multan Institute of Nuclear Medicine and Radiotherapy (MINAR) Cancer Hospital, Multan, Pakistan.

Evans syndrome is a rare autoimmune disease in which an individual's antibodies attacks the body's own red blood cells and platelets.1 There is a coexistence of Immune thrombocytopenia (ITP) with Autoimmune haemolytic anaemia (AIHA) and both of these events may occur simultaneously or one follows the other. 2 Association of Evans syndrome with pregnancy is very rare, and only a few cases have been published in medical literature. Read More

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Epidemiology and management of fetal and neonatal alloimmune thrombocytopenia.

Transfus Apher Sci 2020 Feb 31;59(1):102704. Epub 2019 Dec 31.

Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands.

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease in pregnancy characterized by maternal alloantibodies directed against the human platelet antigen (HPA). These antibodies can cause intracranial hemorrhage (ICH) or other major bleeding resulting in lifelong handicaps or death. Optimal fetal care can be provided by timely identification of pregnancies at risk. Read More

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http://dx.doi.org/10.1016/j.transci.2019.102704DOI Listing
February 2020

Recent advances in non-invasive fetal HPA-1a typing.

Authors:
Núria Nogués

Transfus Apher Sci 2020 Feb 31;59(1):102708. Epub 2019 Dec 31.

Immunohematology Laboratory, Banc de Sang i Teixits, Pg. Taulat 116, 08005 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 129-139, 08035 Barcelona, Spain. Electronic address:

Non-invasive fetal HPA-1a typing is a valuable tool to identify the pregnancies at risk of fetal and neonatal alloimmune thrombocytopenia (FNAIT). At present, prenatal determination of the fetus HPA-1a type is performed for diagnostic purposes in pregnancies of HPA-1 alloimmunized women with history of a previous fetus or child with FNAIT. Different approaches have been used to determine the fetal HPA-1a genotype from cell-free fetal DNA (cffDNA) in the mother's plasma, mainly based on real-time PCR. Read More

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http://dx.doi.org/10.1016/j.transci.2019.102708DOI Listing
February 2020

5 Years' Experience of a Tertiary Center with Thrombocytopenic Pregnancies: Gestational Thrombocytopenia, Idiopathic Thrombocytopenic Purpura and Hypertensive Disorders of Pregnancy.

Geburtshilfe Frauenheilkd 2020 Jan 24;80(1):76-83. Epub 2019 Jul 24.

Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey.

To evaluate thrombocytopenic pregnancies including gestational thrombocytopenia (GT), idiopathic thrombocytopenic purpura (ITP), and hypertensive disorders of pregnancy (HDP). We evaluated the pregnancy outcomes and laboratory findings of 385 patients diagnosed with GT, ITP, or HDP whose thrombocyte levels were < 150 000/µL. GT, ITP, and HDP were the final diagnoses in 315 (81. Read More

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http://dx.doi.org/10.1055/a-0865-4442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6957351PMC
January 2020

Prospects for risk stratification of anti-HPA-1a alloimmunized pregnant women.

Authors:
Ulrich J Sachs

Transfus Apher Sci 2020 Feb 31;59(1):102709. Epub 2019 Dec 31.

Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany; Center for Transfusion Medicine and Hemotherapy, University Hospital Giessen and Marburg, Marburg, Germany; German Center for Fetomaternal Incompatibility (DZFI), University Hospital Giessen and Marburg, Giessen, Germany. Electronic address:

A diagnosis of fetal/neonatal alloimmune thrombocytopenia (FNAIT) is made if a platelet-specific antibody is detected in the mother and the fetus or newborn carries the cognate antigen. Some children will experience very low platelet counts or even intracranial hemorrhage with devastating consequences, whereas others are largely unaffected. At the moment, predictive tools to forecast the severity of FNAIT during pregnancy are not available and over- or under-treatment may put the mother or the fetus at risk. Read More

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http://dx.doi.org/10.1016/j.transci.2019.102709DOI Listing
February 2020

Acute immune trobocytopenic purpura in pregnant adolescent.

Ceska Gynekol 2019 ;84(6):443-449

Objective: The article reviews the causes of thrombocytopenia in pregnancy and the basic examination scheme. Further, it deals in more details with diagnosis of immune thromocytopenic purpura (ITP) and presents a case report of a rare case of acute severe ITP in pregnant adolescent.

Design: Review article and case report. Read More

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January 2020

Genetic and functional analysis of two missense mutations in CD46 predispose to postpartum atypical hemolytic uremic syndrome.

Clin Chim Acta 2020 Apr 13;503:61-69. Epub 2020 Jan 13.

Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing 100034, PR China; Peking-Tsinghua Center for Life Sciences, Peking University, Beijing 100034, PR China. Electronic address:

Pregnancy associated atypical hemolytic uremic syndrome (p-aHUS) is a disease with a triad of hemolytic anemia, thrombocytopenia and acute renal failure, which might be attributed to the uncontrolled complement activation. Herein, we sequenced a postpartum-aHUS patient and found the two missense variants of CD46, a novel mutation (c.403G > C, p. Read More

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http://dx.doi.org/10.1016/j.cca.2020.01.009DOI Listing

Consensus regarding diagnosis and management of atypical hemolytic uremic syndrome.

Korean J Intern Med 2020 Jan 2;35(1):25-40. Epub 2020 Jan 2.

Department of Internal Medicine, CHA University School of Medicine, Seongnam, Korea.

Thrombotic microangiopathy (TMA) is defined by specific clinical characteristics, including microangiopathic hemolytic anemia, thrombocytopenia, and pathologic evidence of endothelial cell damage, as well as the resulting ischemic end-organ injuries. A variety of clinical scenarios have features of TMA, including infection, pregnancy, malignancy, autoimmune disease, and medications. These overlapping manifestations hamper differential diagnosis of the underlying pathogenesis, despite recent advances in understanding the mechanisms of several types of TMA syndrome. Read More

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http://dx.doi.org/10.3904/kjim.2019.388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960041PMC
January 2020

The use of IVIg in fetal and neonatal alloimmune thrombocytopenia- Principles and mechanisms.

Transfus Apher Sci 2020 Feb 31;59(1):102710. Epub 2019 Dec 31.

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, M5S 1A8, Canada; Keenan Research Centre, Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada; Toronto Platelet Immunobiology Group (TPIG), Toronto, ON, M5B 1T8, Canada; Canadian Blood Services, Centre for Innovation, Ottawa, ON, K1G 4J5, Canada; Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, M5S 1A8, Canada. Electronic address:

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare neonatal disorder that is caused by alloimmunization against platelet antigens during pregnancy. Although rare, affecting only 1 in 1000 live births, it can cause intracranial hemorrhage and other bleeding complications that can lead to miscarriage, stillbirth and life-long neurological complications. One of the gold-standard therapies for at risk pregnancies is the administration of IVIg. Read More

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http://dx.doi.org/10.1016/j.transci.2019.102710DOI Listing
February 2020

Severe Platelet Transfusion Refractoriness in Association with Antibodies Against CD36.

Lab Med 2020 Jan 11. Epub 2020 Jan 11.

The Platelet & Neutrophil Immunology Laboratory, Blood Center of Wisconsin (part of Versiti), Milwaukee, WI.

Platelet-transfusion refractoriness (PTR) is common in patients with hematological malignancies. The etiology of immune PTR is typically human leukocyte antigen (HLA) antibodies (Abs) from pregnancy or previous transfusion. Herein, we report PTR in the setting of induction chemotherapy for acute myelogenous leukemia (AML) from Abs against CD36/glycoprotein (GP)IV. Read More

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http://dx.doi.org/10.1093/labmed/lmz091DOI Listing
January 2020

Clinical and pathological features of thrombotic microangiopathy influencing long-term kidney transplant outcomes.

PLoS One 2020 10;15(1):e0227445. Epub 2020 Jan 10.

Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.

Introduction: Thrombotic microangiopathy (TMA) in post-transplant setting has heterogeneous clinical manifestations.

Methods: We retrospectively studied data of 89 patients with post-transplant TMA, which was characterized by thrombi in at least one glomerulus and/or arteriole. Systemic TMA was defined by thrombocytopenia and microangiopathic anemia and early onset TMA, when occurred less than 90 days post transplant. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227445PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953866PMC

Foetal and neonatal alloimmune thrombocytopenia - The role of the HLA-DRB3*01:01 allele for HPA-1a-immunisation and foetal/neonatal outcome.

Transfus Apher Sci 2020 Feb 31;59(1):102707. Epub 2019 Dec 31.

Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.

Foetal and neonatal alloimmune thrombocytopenia (FNAIT) is the platelet counterpart of haemolytic disease of the foetus and newborn. Among Caucasians, around 80 % of FNAIT cases and some of the most severe cases, are caused by alloantibodies against the human platelet antigen 1a (HPA-1a). For around 3 decades it has been known that almost all HPA-1a-immunised women are HLA-DRB3*01:01 positive. Read More

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http://dx.doi.org/10.1016/j.transci.2019.102707DOI Listing
February 2020