Splenectomy during cesarean section in a patient with severe idiopathic thrombocytopenic purpura (ITP) refractory to the medical treatment
2014
Idiopathic thrombocytopenic purpura (ITP) is a disease of women of
reproductive age and accounts for 5% of pregnancy associated
thrombocytopenia. We reported the case of 21-year-old primigravida with ITP
who was admitted to our hospital at the 28th weeks of gestation with platelet
count of 22x109/l. Despite medicament treatment (prednisone, intravenous
immunoglobulin /IgG/) there were falls in the platelet count, last at the
33rd week of gestation when platelet count was 15x109/l. In consultation with
hematologist and surgeon we decided to deliver the patient by cesarean sec-
tion during which splenectomy will be done. Patient received 60g of
intravenous IgG two days before operations which were performed at the 34th
week of gestation. Healthy female infant was born with normal platelet count
and maternal platelet count at the discharge from hospital was 346x109/l.
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