Maternal thrombocytopenia in pregnancy: time for a reassessment

Article Abstract:

Invasive testing and cesarean section may not be useful strategies for managing maternal low platelet count. In autoimmune thrombocytopenic purpura, the mother produces antibodies that attack platelets, a blood component involved in clotting. These antibodies may also destroy fetal platelets. Based on case reports that vaginal birth could cause cerebral hemorrhage in affected infants, routine cesarean has been recommended. Fetal scalp sampling or fetal blood sampling during labor are used to identify affected infants. However, studies show that cesarean sections and fetal blood sampling introduce life-threatening risks, and cesarean section does not prevent cerebral hemorrhage in affected infants. Fetal scalp blood sampling in labor may be difficult or impossible or result in falsely low platelet counts, thus leading to unnecessary cesareans. Moreover, many conditions cause low platelet counts in the mother but do not effect the fetus.

Care and treatment, Pregnant women, Thrombocytopenia

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Anti-beta2-glycoprotein antibodies in women with recurrent spontaneous abortion, unexplained fetal death, and antiphospholipid syndrome

Article Abstract:

Testing for anti-beta2-glycoprotein I antibodies does not appear to be more accurate than testing for anticardiolipin antibodies for diagnosing antiphospholipid syndrome. This syndrome is linked to an increased risk of miscarriage, fetal death and blood clotting abnormalities.

Diagnosis, Autoantibodies, Antiphospholipid syndrome

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