Severe thrombocytopenia resulting in intrauterine exitus in pregnancy and review of the literature

Abstract

Objective: We aimed to present a pregnancy accompanied by severe thrombocytopenia and intrauterine exitus fetus and its management by reviewing the literature. Case report: A 21-year-old patient with a 24-week singleton pregnancy was admitted with the complaints of nausea, vomiting and epistaxis. TA: 110/70 mmHg, heart rate: 85/min. Severe thrombocytopenia (plt: 9000/uL) was found in the patient who did not have any obstetric pathology. Hb: 13 g/dl, ALT: 12 U/ L, AST: 40 U/ L, Albumin: 2.47 g/dl, creatinine: 0.83 mg/dl, total bilirubin: 0.27 mg/dl, and with the preliminary diagnosis of immune thrombocytopenia, 1 U apheresis and 1 U pooled platelet transfusion and 32 mg/day prednol treatment were applied; control plt was 36000/uL. At the patient's follow-up 10 days later, plt: 6000/uL and fetal heart rate were not observed, so termination was decided. Vital signs: TA: 130/80, heart rate: 98/min, fever: 36 0C. Hb: 6.7 g/ dl, plt: 6000/ uL, total bilirubin 0.88 mg/ dl, ALT: 28 U/ L, AST: 70 U/ L, LDH: 2297 U/L, Haptoglobin

Amaç: Şiddetli trombositopeni ve intrauterin exitus fetusun eşlik ettiği bir gebeliği ve bunun yönetimini literatürü gözden geçirerek sunmayı amaçladık Olgu sunumu: 21 yaşında, 24 hafta tekil gebeliği olan hasta, bulantı, kusma, burun kanaması şikayeti ile başvurdu. TA: 110/ 70 mmHg, nabız: 85/ dk idi. Herhangi bir obstetrik patoloji saptanmayan hastada, şiddetli trombositopeni (plt: 9000/ uL) saptandı. Hb: 13 g/ dl, ALT: 12 U/ L, AST: 40 U/ L, Albumin: 2,47 g/ dl, kreatinin: 0,83 mg/dl, total biluribin: 0,27 mg/dl idi ve immün trombositopeni ön tanısı ile, 1 Ü aferez ve 1 Ü havuzlanmış trombosit transfüzyonu ve 32 mg/gün prednol tedavisi uygulandı; kontrol plt: 36000/ uL idi. Hastanın 10 gün sonraki kontrolünde, plt: 6000/ uL ve fetal kalp atımı izlenmemesi üzerine, terminasyon kararı verildi. Vital bulgular: TA: 130/ 80, nabız: 98/ dk, ateş: 36 0C idi. Hb:6,7 g/ dl, plt: 6000/ uL, total biluribin 0,88 mg/ dl, ALT: 28 U/ L, AST: 70 U/ L, LDH: 2297 U/L, Haptoglobin