scholarly journals Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy

Blood ◽  
2016 ◽  
Vol 128 (10) ◽  
pp. 1329-1335 ◽  
Author(s):  
Dongmei Sun ◽  
Nadine Shehata ◽  
Xiang Y. Ye ◽  
Sandra Gregorovich ◽  
Bryon De France ◽  
...  
Keyword(s):  
Platelet Count ◽  
Retrospective Study ◽  
Pregnant Women ◽  
Intravenous Immunoglobulin ◽  
Immune Thrombocytopenia ◽  
Neonatal Outcomes ◽  
Key Points ◽  
Count Response ◽  
In Pregnancy

Key Points Maternal platelet count response was not different for IVIg and corticosteroids in this retrospective study of pregnant women with ITP. Neonatal outcomes were overall favorable and similar after treatment of maternal ITP with IVIg or corticosteroids.

Severe Immune Thrombocytopenia in Pregnancy: Intravenous Immunoglobulin Can Improve Platelet Count Significantly

2020 ◽  
Vol 36 (6) ◽  
pp. 368-371
Author(s):  
Mohamed Fouad Selim ◽  
Manal Mohammad Ali Abdou ◽  
Ali Mohamed Ali Elnabtity
Keyword(s):  
Platelet Count ◽  
Intravenous Immunoglobulin ◽  
Immune Thrombocytopenia ◽  
In Pregnancy

scholarly journals A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy

Blood ◽  
2017 ◽  
Vol 130 (9) ◽  
pp. 1097-1103 ◽  
Author(s):  
Zhangyuan Kong ◽  
Ping Qin ◽  
Shan Xiao ◽  
Hai Zhou ◽  
Hong Li ◽  
...  
Keyword(s):  
Treatment Option ◽  
Immune Thrombocytopenia ◽  
Safe Treatment ◽  
Key Points ◽  
Safe Treatment Option ◽  
Recombinant Human Thrombopoietin ◽  
In Pregnancy

Key Points rhTPO is a potentially effective and safe treatment option for ITP during pregnancy.

A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

2019 ◽  
Vol 47 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Stephanie O. Keeling ◽  
Samantha L. Bowker ◽  
Anamaria Savu ◽  
Padma Kaul
Keyword(s):  
Rheumatoid Arthritis ◽  
Pregnant Women ◽  
Population Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Neonatal Outcomes ◽  
Hypertensive Disorder ◽  
Antiinflammatory Drugs ◽  
Hypertensive Disorders ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

scholarly journals Immune thrombocytopenia - in defence of the platelet count. Response to Hill

2017 ◽  
Vol 182 (1) ◽  
pp. 130-131
Author(s):  
María T. Álvarez Román ◽  
Ihosvany Fernández Bello ◽  
Víctor Jiménez-Yuste ◽  
Mónica Martín Salces ◽  
Elena G. Arias-Salgado ◽  
...  
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenia ◽  
Count Response

Effect of Pregnancy in Women with a History of Primary Immune Thrombocytopenia Considered As Cured

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2552-2552
Author(s):  
Thibault Comont ◽  
Guillaume Moulis ◽  
Karen Delavigne ◽  
Pierre Cougoul ◽  
Olivier Parant ◽  
...  
Keyword(s):  
Platelet Count ◽  
Complete Remission ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Immune Thrombocytopenia ◽  
Specific Treatment ◽  
Severe Bleeding ◽  
Adult Women ◽  
History Of ◽  
The Impact

Abstract Immune thrombocytopenia (ITP) is an autoimmune disease that occurs in young women. Pregnancy is a well-known risk factor for developing newly diagnosed ITP as well as for inducing disease flares in patients with current ITP. However, the impact of pregnancy in women with an old history of ITP, considered as cured, has not been assessed. The aim of this study was to describe the course of ITP in pregnant women with an ITP in complete remission (platelets count >100x109/L and absence of bleeding symptoms) for at least 5 years without any ITP treatment. We retrospectively selected all pregnant women with delivery at Toulouse University Hospital, South of France, between 2010 and 2015 with a hospital discharge code of ITP (international classification of diseases; version 10 code D69.3). This code has a sensitivity of 81.2% and a positive predictive value of 89.8% in this database. All medical charts were reviewed to confirm the diagnosis of ITP. We included adult women (≥18 years) with a diagnosis of primary ITP according to French guidelines (platelet count <150 x 109 /L and exclusion of other causes of thrombocytopenia, especially other causes of thrombocytopenia during pregnancy) in complete remission for at least 5 years. We identified 50 pregnancies in 39 ITP patients during the study period. Eleven pregnancies occurred in 10 patients in long-term complete remission of ITP at the time of pregnancy onset. Baseline characteristics were: median age at ITP diagnosis: 21 years (range: 4-29); median age at pregnancy onset:32 years (range: 26-34; history of ITP during a previous pregnancy: 1; history of bleeding: 4 (36.4%); previous treatment for ITP: 8 (72.7%), corticosteroids-CS (5), CS and intravenously immunoglobulin-IVIg (3), splenectomy (4), dapsone (1); last median platelet count before pregnancy: 170x109/L (range: 118-363). Platelets count decreased below 100x109/L in 3 pregnancies (27.2%) from the first trimester for one patient, from the second trimester for one other and from the third trimester for the last one, with a nadir of 3, 39 and 87 (x109/L) respectively. One of them experienced a severe bleeding (grade 3 according to the International Working Group bleeding classification). All thrombocytopenic patients required treatment during pregnancy: CS+IVIg for 2 (one for bleeding and one to allow epidural analgesia) and IVIg for the other (to allow epidural analgesia). For these 3 women, the median platelet count at delivery was 128 (range: 38-159) and consequently only 2 of them could have epidural analgesia. No bleeding during delivery was observed. Transient thrombocytopenia occurred in 2 newborns. Primary ITP considered as cured may relapse during pregnancy and may induce severe bleeding requiring specific treatment. A tight monitoring should be proposed to all pregnant women with a history of primary ITP, even after several years of complete remission. Disclosures Récher: Celgene, Sunesis, Amgen, Novartis, Chugai: Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals A RETROSPECTIVE STUDY ON PREVALANCE OF ANEMIA IN PREGNANCY IN A TERITIARY CARE HOSPITAL

2021 ◽  
pp. 106-108
Author(s):  
SYEDA ZAINEB KUBRA HUSSAINI ◽  
BUSHRA SHEREEN ◽  
SIRISHA D ◽  
MADHAVI E ◽  
HARI PRIYA E ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Iron Therapy ◽  
Care Hospital ◽  
Oral Iron Therapy ◽  
Moderate Anemia ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objective: To study about prevalence in anemia among the antenatal women, its clinical features, and access the severity and its treatment response. Methods: A hospital-based retrospective study on the prevalence of anemia among the antenatal women in tertiary care hospital for 6 months duration in gynecology and obstetrics department. In evaluating pregnant women with anemia, it is essential to do a complete history and physical examination, as well as complete blood count with indices and a blood smear examination. Based on these findings, other test such as ferritin and serum or red cell folate may be ordered. Because of normal physiologic changes in pregnancy that effect the hematocrit, indices, and some other parameters, diagnosing true anemia, as well as the etiology of anemia, is challenging. Results and Discussion: In this retrospective study, the prevalence of Anemia in pregnancy in a tertiary care hospital was evaluated and determined in fifty patients. The most common age group was between 21 and 25 years i.e., (21 patients) 42%. Among 50 patients, majority of them, i.e., 35 patients (70%) were treated with Injection. Iron Sucrose (200 mg). In this study, increase in prevalence were seen majorly in the third trimester, i.e., 25 patients (50%) of which 22 patients (88%) were with moderate anemia with 7.9 gm/dl average hemoglobin (Hb) percentage and 3 patients (12%) were with mild anemia with 9.3 gm/dl average Hb percentage. Conclusion: The plan of management for anemia complicating pregnancy depends on the type of anemia. Oral iron therapy is the route of choice in women with mild to moderate anemia and for severe anemia in pregnant women <30 weeks of gestation. The rise of Hb with parenteral iron therapy is almost the same (avg: 1gm/dl/week) as that of oral iron therapy.

scholarly journals Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 193-203
Author(s):  
Phoibe Uwizeyimana ◽  
Emerthe Musabyemariya ◽  
Olive Tengera ◽  
Anita Collins
Keyword(s):  
Retrospective Study ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
University Teaching ◽  
Delivery Mode ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Maternal Hypertension ◽  
In Pregnancy

Background Globally, maternal hypertensive disorders in pregnancy significantly increase both maternal and perinatal morbidity and mortality. Maternal hypertension affects 14 percent of pregnancies. Eearly detection and management are critical for improving the health outcomes of both mother and neonate. Objective To assess the association between maternal hypertension disorders in pregnancy and immediate neonatal outcomes at a University Teaching Hospital in Rwanda. Methods A retrospective study of maternal files with hypertension disorders was conducted from January 1, 2016, to March 31, 2019. A census sample of 114 records and pretested checklist was used to collect data. Descriptive statistics were used to analyze associations between maternal factors and immediate neonatal outcomes. Results Neonatal outcomes included low birth weight (75.4%), prematurity (59.6%), admission to neonatal intensive care unit (50.4%), intrauterine growth restriction (32.4%), and neonatal death (22.8%). Nearly two-thirds (62%) of mothers had preeclampsia. Significant associations with immediate neonatal outcomes included gestational age, medical history, delivery mode, maternal referral status, preterm birth, prematurity, and abortion. Conclusion Maternal hypertensive disorders were significantly associated with adverse neonatal outcomes in our study population in Rwanda. Improving early detection, health education, and management of hypertensive disorders in pregnancy is critical to reduce maternal and neonatal morbidity and mortality. Rwanda J Med Health Sci 2020;3(2):193-203

Are Haemostatic and Fibrinolytic Parameters Predictors of Preeclampsia in Pregnancy-Associated Hypertension?

1991 ◽  
Vol 66 (04) ◽  
pp. 410-414 ◽  
Author(s):  
C Caron ◽  
J Goudemand ◽  
A Marey ◽  
D Beague ◽  
G Ducroux ◽  
...  
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Plasma Levels ◽  
High Dispersion ◽  
Positive Correlation ◽  
Before And After ◽  
Group A ◽  
Fibrinolytic Parameters ◽  
Pai 1 ◽  
In Pregnancy

SummaryThe plasma levels of several haemostatic and fibrinolytic parameters were measured before and after delivery in 61 hypertensive pregnant women of whom 22 developed preeclampsia, and compared to the results obtained in 42 normal pregnant women. In the two last weeks before delivery (D ≤ –15) tPA antigen, PAI-1 activity, vWF: Ag/FVIII: C ratio, ATIII activity and platelet count were found to be significantly different in the hypertensive pregnant women with and without preeclampsia. Combined all together, an association of three of these five parameters were found to be pathological (i.e.: tPA: Ag ≥19 ng/ml, PAI-1 activity ≥58 IU/ml, vWF: Ag/FVIII: C ratio 5≥2.6, ATIII activity ≤73%) in none of the hypertensive women without preeclampsia and in only 35% of the preeclamptic group. A positive correlation was demonstrated between vWF:Ag/FVIII:C ratio and tPA:antigen levels suggesting that both tPA and vWF: Ag could be considered as early indicators of a possible micro angiopathy occurring in preeclampsia. However, due to the high dispersion of the results, it appears that the investigated haemostatic and/or fibrinolytic criteria give only presumptive arguments before assigning risk for preeclampsia development among hypertensive pregnant women.

scholarly journals REGAIN STUDY: Retrospective Study to Assess the Effectiveness, Tolerability, and Safety of Ferric Carboxymaltose in the Management of Iron Deficiency Anemia in Pregnant Women

Anemia ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Saleema Wani ◽  
Mariyam Noushad ◽  
Shabana Ashiq
Keyword(s):  
Retrospective Study ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Blood Hemoglobin ◽  
Iv Iron ◽  
In Pregnancy

Iron deficiency anemia (IDA) during pregnancy arises because of preexisting inadequate stores or complex physiological changes and can lead to serious maternal and fetal complications. Oral iron, either as iron sulfate or fumarate, with or without folic acid, is the most commonly used treatment for IDA in pregnancy. Intravenous (IV) iron has a role in the treatment of IDA in pregnancy, particularly in women who present late, display severe anemia (Hb ≤ 9 g/dL), or risk factors, and are intolerant/noncompliant of oral iron. Previously, administration of IV iron was minimal, owing to potentially serious anaphylactic reactions. Recently, new IV iron products have been developed, offering better compliance, tolerability, efficacy, and a good safety profile. Our study aimed to assess the effectiveness, safety, and tolerability of IV ferric carboxymaltose (FCM) in the treatment of IDA in pregnant women in the UAE. Data from 1001 pregnant women who received at least one administration of FCM (500, 1000, or 1500 mg) during their second or third trimester of pregnancy (2 years backward from study initiation) were collected retrospectively from electronic medical records at Corniche Hospital, Abu Dhabi, UAE. Results showed that 41.4% of the women were able to achieve an increase of ≥2 g/dL in blood hemoglobin overall. A change of ≥2 g/dL was achieved by 27.5% of women administered a dose of 500 mg, 39.2% of women administered a dose of 1000 mg, and 63.9% of women administered a dose of 1500 mg of IV FCM. This indicates a directly proportional relationship between increasing IV FCM dose and the increase of ≥2 g/dL in blood hemoglobin. A total of 7 (0.7%) women reported mild, nonserious adverse events during the study. Within the limits of this retrospective study, IV FCM therapy was safe and effective in increasing the mean hemoglobin of pregnant women with IDA.

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