South Clin Ist Euras. 2014; 25(2): 89-94 | DOI: 10.5505/jkartaltr.2014.25582

Gebelikte trombositopeni saptanan olgularýn fetomaternal sonuçlarý

Burcu Artunc Ulkumen, Filiz Aktenk, Yesim Baytur
Celal Bayar Üniversitesi Týp Fakültesi Kadýn Hastalýklarý Ve Doðum Ad,manisa

AMAÇ: Gebelikte trombositopeni saptanan olgularýn fetal ve maternal sonuçlarýnýn saðlýklý gebelikler ile karþýlaþtýrýlmasý.
YÖNTEMLER: Ocak 2008-Ocak 2013 tarihleri arasýnda kliniðimizde takip edilmiþ trombositopeni olan 80 gebe ile saðlýklý 80 gebenin fetal ve maternal sonuçlarý retrospektif olarak dosya kayýtlarýndan incelenmiþtir.
BULGULAR: Trombositopeni etiyolojisi incelendiðinde en sýk neden 31 hastada gestasyonel trombositopeni olarak deðerlendirilmiþtir. 34 hastada aðýr preeklampsi, 6 hastada eklampsi, 2 hastada HELLP sendromu ve 7 hastada idiopatik trombositopenik purpura (ITP) izlenmiþtir. Trombositopenik gebelerin yaþ ortalamasý 29.41±5.48, kontrol grubunun 29.80±5.98 olarak saptanmýþtýr (p 0,670). Trombositopenik gebelerde primer sezaryen oraný %48.75 (39/80) iken kontrol grubunda primer sezaryen oraný %23.75 (19/80) olup istatistiksel olarak anlamlýdýr (p < 0.05). Gestasyonel trombositopeni olan olgularýn 13 tanesi normal doðum yapmýþtýr. Diðer olgular sezaryen olmuþtur. Erken doðum ve düþük doðum kilosu trombositopenik grupta daha sýk izlenmiþtir.
SONUÇ: Gebelikte trombositopeni, anemiden sonra en sýk karþýlaþýlan hematolojik komplikasyondur. Trombositopeni saptandýðýnda öncelikle olumsuz perinatal sonuçlar yaratan preeklampsi ve HELLP düþünülmelidir. En sýk etiyolojik etken olan gestasyonel trombositopenide fetomaternal sonuçlar daha iyidir.

Anahtar Kelimeler: Gebelik, trombositopeni, preeklampsi, HELLP, gestasyonel trombositopeni.

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Feto-maternal outcomes of pregnancies with thrombocytopenia

Burcu Artunc Ulkumen, Filiz Aktenk, Yesim Baytur
Celal Bayar University, School of medicine, Department of Obstetrics and gynecology,Manisa

OBJECTIVE: to compare the feto-maternal outcomes between healthy and thrombocytopenic pregnancies.
METHODS: the data of the pregnancies with thrombocytopenia (n: 80) admitted to our clinic between January 2008-January 2013 are evaluated retrospectively. The data of the healthy pregnancies (n: 80) were randomly selected during the same period.
RESULTS: the most common cause of thrombocytopenia was gestational thrombocytopenia found in 31 pregnancies. 34 patients had preeclampsia, 6 patients had eclampsia, 2 patients had HELLP syndrome and 7 had idiopathic thrombocytopenic purpura (ITP). The mean age was 29.41±5.48 and 29.80±5.98 in thrombocytopenic pregnancies and healthy pregnancies, respectively (p 0,670). Primary cesarean ratio was %48.75 (39/80) in thrombocytopenic group, whereas it was %23.75 (19/80) in control group (p < 0.05). Only 13 of the patients with gestational thrombocytopenia had spontaneous vaginal labor, the rest of the thrombocytopenic group had cesarean. Preterm birth and low birth weight were more common in the pregnancies with thrombocytopenia.
CONCLUSION: Thrombocytopenia during pregnancy is the second most common hematologic complication after anemia. Once thrombocytopenia is detected during pregnancy, preeclampsia and HELLP must be kept in mind because of the adverse perinatal outcomes. Feto-maternal outcomes are better in gestational thrombocytopenia.

Keywords: Pregnancy, thrombocytopenia, preeclampsia, HELLP, gestational thrombocytopenia

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