Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Her infant will most likely require a platelet transfusion postpartum.
0%
0/9
She will continue to be asymptomatic and her thrombocytopenia will resolve spontaneoulsy postpartum.
She will continue to have low platelets postpartum which will most likely require steroids and/or a splenectomy.
She will most likely progress to eclampsia without treatment
78%
7/9
She will most likely require several platelet transfusions intrapartem.
22%
2/9
Select Answer to see Preferred Response
The patient in this case has gestational thrombocytopenia, defined as thrombocytopenia developing during pregnancy. This condition resolves spontaneously after delivery and does not require intervention.Gestational thrombocytopenia is not related to the preeclampsia, eclampsia, or HELLP syndrome (Hemolysis, Elevated LFTs, Low Platelets) spectrum of thrombocytopenic disease. These illnesses are much more severe and present with widespread symptoms. Gestational thrombocytopenia is characterized by mild thrombocytopenia (with platelet count almost always >100,000), otherwise normal CBC findings, and normal counts before and after pregnancy. This is most commonly seen in the 3rd trimester and poses no risk to the mother or fetus. The management of gestational thrombocytopenia is conservative with reassurance and observation. Pishko et al. discuss the clinical presentation, diagnosis and management of gestational thrombocytopenia. They note the benign nature of this phenomenon and recommend conservative management with reassurance observation. They also discuss distinguishing gestation thrombocytopenia from other thrombocytopenic disorders of pregnancy such as preeclampsia or HELLP syndrome. Illustration A outlines the relationship of the thrombocytopenic conditions of pregnancy. Incorrect Answers:Answer 1: Infants born to mothers with immune thrombocytopenia (ITP) may develop thrombocytopenia as maternal IgG directed against gpIIaIIIb may cross the placenta. However, this patients clinical presentation is most consistent with gestational thrombocytopeniaAnswer 3: Adult patients with immune thrombocytopenia may require recurrent platelet transfusions and eventual splenectomy. However, this patient's platelet count and lack of bruising or bleeding make ITP unlikely. This patient's presentation is most consistent with gestational thrombocytopenia.Answer 4: Progression to eclampsia often occurs in patients with HELLP syndrome. However, this patient has isolated thrombocytopenia without other associated laboratory abnormalities. Gestational thromboyctopenia is not associated with preeclampsia or eclampsiaAnswer 5: Need for recurrent platelet transfusion can occur in a number of different hematologic disorder. However, gestational thrombocytopenia does not require platelet transfusion (platelet counts are almost always >100,000) and resolves spontaneously. Bullet summary:Gestational thrombocytopenia is a benign cause of thrombocytopenia in pregnancy, often with only mildly low platelet counts and does not require any intervention.
4.6
(5)
Please Login to add comment