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Clin Sci (Lond) 2021 May;135(9):1083-1101

Department of Health and Human Physiology, University of Iowa, IA, U.S.A.

Preeclampsia is a hypertensive disorder of pregnancy effecting ∼5-8% of pregnancies in the United States, and ∼8 million pregnancies worldwide. Preeclampsia is clinically diagnosed after the 20th week of gestation and is characterized by new onset hypertension accompanied by proteinuria and/or thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms. This broad definition emphasizes the heterogeneity of the clinical presentation of preeclampsia, but also underscores the role of the microvascular beds, specifically the renal, cerebral, and hepatic circulations, in the pathophysiology of the disease. Read More

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211014575

Aspen Pharma, München, Germany.

We analyzed data for women who received fondaparinux for ≥7 days during pregnancy. The study retrospectively included women who received fondaparinux pre-, peri- and/or postpartum for ≥7 days for prophylaxis/venous thromboembolism (VTE) treatment at German specialist centers (2004-2010). Data on pregnancy, VTE risk factors, anticoagulant treatment, pregnancy outcome and adverse events were extracted from medical records. Read More

Clin Case Rep 2021 Apr 14;9(4):2032-2035. Epub 2021 Feb 14.

Department of Gynecology and Obstetrics West China Second University Hospital Sichuan University Chengdu China.

Pregnancy may aggravate myelodysplastic syndrome. Cross-matched platelets can be used in cases of refractory thrombocytopenia. Vaginal delivery can be attempted if the platelet count is at least 20 × 10/L. Read More

Br J Anaesth 2021 Apr 27. Epub 2021 Apr 27.

Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, ON, Canada; School of Baccalaureate Nursing, St. Lawrence College, Kingston, ON, Canada.

Toxicol Rep 2021 20;8:871-879. Epub 2021 Apr 20.

Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.

The COVID-19 pandemic has had an unprecedented and devastating impact on public health, society and economics around the world. As a result, the development of vaccines to protect individuals from symptomatic COVID-19 infections has represented the only feasible health tool to combat the spread of the disease. However, at the same time the development and regulatory assessment of different vaccines has challenged pharmaceutical industries and regulatory agencies as this process has occurred in the shorter time ever though. Read More

Pan Afr Med J 2021 20;38:67. Epub 2021 Jan 20.

Université Cadi Ayyad, Faculté de Médecine et de Pharmacie de Marrakech, Marrakech, Maroc.

Prior to 1970, maternal alloimmunization was the leading cause of perinatal death. Currently, it has become rarer thanks to screening and monitoring in high-risk pregnancies. The advent of transcranial doppler has been a turning point in the monitoring of these pregnancies, as it is a reliable, non-invasive method for the diagnosis of fetal anemia. Read More

N Engl J Med 2021 04;384(16):e73

J Clin Virol 2021 May 9;138:104758. Epub 2021 Feb 9.

School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan; Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam. Electronic address:

Objectives Neonatal dengue has been reported in the literature with contradictory findings of clinical characteristics and diagnosis; thereby, misdiagnosis of neonatal dengue has been frequently reported. We aim to delve into the epidemiology, clinical features, and outcomes of neonatal dengue, thus avoid misdiagnosis and obtain early intervention. Study design A retrospective study was conducted at Children's Hospital 1, Ho Chi Minh, Vietnam with laboratory-confirmed dengue in neonates by positive viral antigen nonstructural protein one rapid test (NS1) and positive IgM antibody for dengue by MAC-ELISA. Read More

Anesth Analg 2021 Feb 4. Epub 2021 Feb 4.

From the *Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan †Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota ‡Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York §Department of Medicine, University of Washington School of Medicine, Seattle, Washington ‖Department of Medicine, Medical College of Wisconsin and Versiti, Milwaukee, Wisconsin ¶Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina #Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee **Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Langone Health, New York, New York ††Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, Liaison for the American College of Obstetricians and Gynecologists ‡‡Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts §§Taubman Health Sciences Library, University of Michigan Medical School, Ann Arbor, Michigan ‖‖Department of Medicine, University of Florida, Gainesville, Florida ¶¶Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina ##Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York *#x002A;*Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York.

Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential morbidity associated with general anesthesia for cesarean delivery, thoughtful consideration of which patients with thrombocytopenia are likely to have an increased risk of spinal epidural hematoma with neuraxial procedures, and when these risks outweigh the relative benefits is important to consider and to inform shared decision making with patients. Because there are substantial risks associated with withholding a neuraxial analgesic/anesthetic procedure in obstetric patients, every effort should be made to perform a bleeding history assessment and determine the thrombocytopenia etiology before admission for delivery. Read More

Clin Kidney J 2021 Apr 22;14(4):1126-1135. Epub 2020 Jun 22.

Department of Nephrology, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.

Background: Atypical hemolytic uremic syndrome (aHUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia and kidney injury caused by a dysregulation of the alternative complement pathway.

Methods: We conducted a multicenter nonregistry study aimed at collecting clinical, laboratory and genetic information of patients with aHUS in Brazil. Demographic data, genetic findings, treatments and outcomes are presented. Read More

Am J Obstet Gynecol 2021 Apr 8. Epub 2021 Apr 8.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology; Columbia Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.

Fetal and Neonatal AlloImmune Thrombocytopenia (FNAIT), the platelet equivalent of Hemolytic Disease of the Fetus and Newborn (HDFN), can have devastating effects on both the fetus and neonate. Current management of FNAIT in a subsequent affected pregnancy involves antenatal administration of IVIG and prednisone to the pregnant woman in order to prevent the development of severe fetal thrombocytopenia and secondary intracranial hemorrhage (ICH) in utero. That therapy has proven to be highly effective, but is associated with maternal side effects and is expensive. Read More

J Infect 2021 Apr 5. Epub 2021 Apr 5.

ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi 110077, India. Electronic address:

Objectives: A systematic review and meta-analysis (SR-MA) of the available Indian literature on severe vivax malaria (SVM) was undertaken.

Methods: Relevant studies in eight electronic databases were retrieved and reviewed. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Read More

J Clin Med 2021 Mar 17;10(6). Epub 2021 Mar 17.

Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder mainly characterised by increased risks of thrombosis and pregnancy morbidity and persistent positive test results for antiphospholipid antibodies (aPLs). The criteria for diagnosing juvenile APS have yet to be validated, while the Sydney classification criteria do not contain several non-thrombotic clinical manifestations associated with the presence of aPLs. As such, difficulties have been encountered in the diagnosis of patients who have no certain thrombotic occlusions. Read More

Ther Adv Hematol 2021 19;12:20406207211001139. Epub 2021 Mar 19.

Division of Hematology and Oncology, Seidman Cancer Center, University Hospitals, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

The treatment of immune thrombocytopenia (ITP) in adults has evolved rapidly over the past decade. The second-generation thrombopoietin receptor agonists (TPO-RAs), romiplostim, eltrombopag, and avatrombopag are approved for the treatment of chronic ITP in adults. However, their use in pregnancy is labeled as category C by the United States Food and Drug Administration (FDA) due to the lack of clinical data on human subjects. Read More

Pan Afr Med J 2020 29;37:382. Epub 2020 Dec 29.

Department of Pediatrics, Mohammed VI University of Health Sciences, Casablanca, Morocco.

Thrombocytopenia is a common hematologic disorder in the neonatal period. It can occur in neonates hospitalized in the Intensive Care Unit and in preterm infants. It is characterized by a platelet count of less than 150. Read More

Rev Med Interne 2021 Mar 25. Epub 2021 Mar 25.

Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Hospices civils de Lyon, pôle IMER, 69003 Lyon, France; University Lyon, University Claude Bernard Lyon 1, HESPER EA 7425, 69008 Lyon, France. Electronic address:

Introduction: Spontaneous adrenal hemorrhages (AH) are a rare condition with no consensus about their management.

Methods: Patients were identified using the Medicalization of the Information System Program database, imaging software and a call for observations to internists, intensivists and obsetricians working at our institution. Adult patients whose medical records were complete and whose diagnosis was confirmed by medical imaging were included. Read More

Asian J Transfus Sci 2020 Jul-Dec;14(2):142-148. Epub 2020 Dec 19.

Department of Nephrology, Jaypee Hospital, Noida, Uttar Pradesh, India.

Introduction: Diagnosis of postpartum thrombotic microangiopathies in pregnancy is a challenge, but plasma exchange (PE) is life-saving in such cases. This study was conducted with the aim to find the result of the early start of PE in such patients.

Materials And Methods: There were a total of seven clinically diagnosed cases of post partum thrombotic microangiopathies (PP-TMA) where PE was done. Read More

Ital J Pediatr 2021 Mar 23;47(1):69. Epub 2021 Mar 23.

Neonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Background: Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women with highly active disease who plan a pregnancy or have an unplanned pregnancy, after accurate counseling about eventual maternal disease relapse due to therapy suspension.

Case Presentation: This brief case report describes a case of documented anemia that we observed in a newborn whose mother with relapsing-remitting multiple sclerosis was treated with an extended dosing protocol of natalizumab throughout pregnancy. Read More

J Obstet Gynaecol Res 2021 May 9;47(5):1892-1897. Epub 2021 Mar 9.

Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.

We herein report the case of a 28-year-old pregnant woman with an acute presentation of remarkable petechiae on her lower extremities and severe thrombocytopenia (16 000/mm ) at the 35th week of gestation. Although idiopathic thrombocytopenic purpura was initially suspected, subsequent examinations revealed that her ADAMTS13 (a Disintegrin And Metalloprotease, with ThromboSpondin type 1 repeats, member 13) titer was extremely decreased, while she was negative for antibodies against ADAMTS13. Infusion of fresh frozen plasma was immediately performed, and the platelet count was observed to increase. Read More

Ginekol Pol 2021 Mar 10. Epub 2021 Mar 10.

Department of Obstetrics and Gynecology, Lishui People's Hospital, affiliated Hospital 6 to Wenzhou Medical University, Lishui, China.

Objectives: To analyze the outcomes of pregnancies and risk factors in Chinese women with different stages of systemic lupus erythematosus (SLE).

Material And Methods: A total of 55 conceptions in 52 patients with SLE between Jan 2007 and Jan 2019 were retrospected systematically from a general hospital graded 3A in China. Medical records provided us a good way to retrieve the clinical parameters and lab data of patients. Read More

Cardiol Young 2021 Mar 16:1-3. Epub 2021 Mar 16.

Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Pregnancy in a woman with double outlet right ventricle, ventricular septal defect, and pulmonary stenosis is presented. Her previous two pregnancies ended in fetal losses. In the current pregnancy, she had thrombocytopenia, placenta previa, and severe fetal growth restriction. Read More

Int J Reprod Biomed 2021 Feb 21;19(2):191-204. Epub 2021 Feb 21.

Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the susceptibility amongst different groups of the population. Pregnant women are one such group. This study was conducted to investigate the effect of COVID-19 on pregnancy and maternal/neonatal outcomes. Read More

Pregnancy Hypertens 2021 Mar 5;24:73-78. Epub 2021 Mar 5.

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Objectives: To determine the trajectories of platelet counts and the prevalence of gestational thrombocytopenia (<150 × 10/L) during normal pregnancies and pregnancies with complications, such as hypertensive disorders of pregnancy (HDP), preeclampsia, and fetal growth restriction (FGR).

Study Design: A multicenter retrospective study was conducted using laboratory data on women who delivered term singletons at 11 primary maternity care units between 2011 and 2018 (n = 35,045), and non-pregnant women who underwent a medical check-up between 2016 and 2019 (n = 61,189). After 1:1 matching, 28,073 pregnant women and 28,073 non-pregnant women were selected for analysis. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2021 Mar;23(3):242-247

Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China.

Objective: To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs).

Methods: A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. Read More

Trials 2021 Mar 10;22(1):202. Epub 2021 Mar 10.

St. Michael's Hospital, Applied Health Research Centre, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Canada.

Objectives: To determine the effect of therapeutic anticoagulation, with low molecular weight heparin (LMWH) or unfractionated heparin (UFH, high dose nomogram), compared to standard care in hospitalized patients admitted for COVID-19 with an elevated D-dimer on the composite outcome of intensive care unit (ICU) admission, non-invasive positive pressure ventilation, invasive mechanical ventilation or death up to 28 days.

Trial Design: Open-label, parallel, 1:1, phase 3, 2-arm randomized controlled trial PARTICIPANTS: The study population includes hospitalized adults admitted for COVID-19 prior to the development of critical illness. Excluded individuals are those where the bleeding risk or risk of transfusion would generally be considered unacceptable, those already therapeutically anticoagulated and those who have already have any component of the primary composite outcome. Read More

Zhonghua Xue Ye Xue Za Zhi 2021 Jan;42(1):33-38

Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences, Beijing 100730, China.

To cross-sectionally analyze the clinical characteristics of primary antiphospholipid syndrome (PAPS) patients with thrombocytopenia, risk factors associated with thrombocytopenia, and risk of symptom recurrence in these patients. The inpatients with PAPS were retrospectively analyzed in Peking Union Medical College Hospital from 2009 to 2019. Using the collected clinical and laboratory data, the clinical characteristics and risk of symptom recurrence in the PAPS patients with thrombocytopenia were compared with those in the PAPS patients with normal platelet counts. Read More

Rev Inst Med Trop Sao Paulo 2021 1;63:e15. Epub 2021 Mar 1.

Universidade CEUMA, São Luís, Maranhão, Brazil.

Congenital cytomegalovirus infection causes lethal diseases with neurological, visual, auditory and systemic injuries, including the hemophagocytic syndrome. Hemophagocytic lymphohistiocytosis (HLH) can be caused by primary hereditary immunological defects, as well as several infectious triggering factors, such as viruses, bacteria and fungus, among them the cytomegalovirus (CMV). Here we present the case report of a male newborn male, delivered by cesarean at term (gestation age of 39 weeks), weighing 3,250 g, with suffusion skin lesions spread throughout the body, anemia, generalized edema, hepatosplenomegaly, thrombocytopenia associated with grunts and difficulty breathing, treated with ganciclovir after receiving the diagnosis of congenital CMV infection. Read More

Cureus 2021 Jan 29;13(1):e12990. Epub 2021 Jan 29.

Anesthesiology, McGovern Medical School, University of Texas Health Science Center, Houston, USA.

Thrombocytopenia occurs in one-third of patients with coronavirus disease 2019 (COVID-19) infection and can indicate the severity of disease and may also increase the bleeding risk of performing invasive procedures. We present a pregnant patient with COVID-19 infection with the lowest platelet count described in the literature to date. The patient presented in labor at 38 weeks gestation with no other symptoms and was found to be positive on routine COVID-19 testing. Read More

J Med Case Rep 2021 Mar 1;15(1):104. Epub 2021 Mar 1.

Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Pregnancy seems to increase the risk of thrombotic thrombocytopenic purpura (TTP) relapses and make the TTP more severe in any of the pregnancy trimesters, or even during the postpartum period.

Case Presentation: This study highlights details of treating a COVID-19 pregnant patient who survived. This 21-year addicted White woman was admitted at her 29th week and delivered a stillbirth. Read More