Julie Godefroi (1), Patricia Steenhaut (2), Matthieu Ortegat (3)Published in the journal : October 2024Category : Obstétrique
Maternal thrombocytopenia (<150,000 platelets/µL) occurs in 5 to 10% of pregnancies. Differential diagnosis can be difficult, but it is essential to offer appropriate antenatal monitoring and treatment. Indeed, thrombocytopenia during pregnancy can lead to maternal, fetal, and neonatal complications.
After ruling out pseudothrombocytopenia, a distinction is made between isolated thrombocytopenia (gestational thrombocytopenia and immune thrombocytopenic purpura) and thrombocytopenia associated with hemolytic anemia (pre-eclampsia, HELLP syndrome and microangiopathies). In this article, we will describe these different pathologies in detail and offer diagnostic keys, before outlining current knowledge regarding treatment, antenatal monitoring, delivery, as well as neonatal period and post-partum periods.
An algorithm to facilitate the differential diagnosis of thrombocytopenia in pregnant women is proposed at the end of this article.
Moïra Poncelet (1), Catherine Lambert (2), Pierre Bernard (1)Published in the journal : January 2021Category : Obstétrique
Autoimmune hemolytic anemia, specifically during pregnancy, is an uncommon hematological disorder, which causes premature destruction of red blood cells. While it may be idiopathic, this disorder may also be secondary to an underlying condition. Whatever its etiology, this disease is associated with high maternal, fetal, and neonatal morbidity, which is due to the transplacental passage of immunoglobulins G (IgG). This highlights the usefulness of diagnosing and managing this pathology, which is a real challenge, given the lack of codified recommendations published in the literature.
Corinne Hubinont, Frédéric Debieve, Pierre BernardPublished in the journal : May 2020Category : Obstétrique
The COVID-19 pandemia may affect pregnant women. Though the vast majority of infected pregnant patients are asymptomatic, about 9% exhibit symptoms of pneumonia, which must be diagnosed and appropriately treated. The first published papers suggested a management similar to that of non-pregnant patients in terms of diagnostic tests and therapies. Given the increased risk of preterm labor, corticosteroids for fetal lung maturation should be administrated in case of imminent labor. The delivery route should be chosen based on obstetrical data even if elective caesarian section was reported in most published patients. Loco-regional anesthesia is permitted. Only a few cases of maternal-fetal transmission have been reported to date, with transmission mainly occurring during and after delivery. Perinatal morbidity and mortality have been shown to be very low. Only one maternal death was reported so far. Breastfeeding is possible using specific hygiene measures, such as hand washing and surgical mask wearing. In conclusion, this up-to-date literature review suggests that COVID-19-infected pregnant women and their newborn face a good outcome. However, more information from large multicenter studies must be collected, in an effort to confirm these encouraging data.