Laparoscopic Splenectomy for the Treatment of Refractory Immune Thrombocytopenia in Pregnancy

被引：25

作者：

Griffiths, Jill ^{[1
]}

Sia, Winnie ^{[1
,2
]}

Shapiro, A. M. James ^{[3
]}

Tataryn, Ivanna ^{[1
]}

Turner, A. Robert ^{[2
]}

机构：

[1] Univ Alberta, Dept Obstet & Gynecol, Edmonton, AB, Canada

[2] Univ Alberta, Dept Med, Edmonton, AB, Canada

[3] Univ Alberta, Dept Surg, Edmonton, AB, Canada

来源：

JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA | 2005年 / 27卷 / 08期

关键词：

Idiopathic thrombocytopenic purpura; splenectomy; pregnancy; systemic lupus erythematosis; laparoscopy;

D O I：

10.1016/S1701-2163(16)30729-0

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Background: Immune thrombocytopenic purpura (ITP) is a condition with potential hazard during pregnancy for both mother and fetus if platelet concentrations fall below a critical level. This report describes the use of laparoscopic splenectomy following unsuccessful medical management. Case: A 35-year-old primigravid woman with systemic lupus erythematosis (SLE) developed ITP several years before becoming pregnant. She was treated early in pregnancy with high-dose oral prednisone and weekly intravenous immunoglobulin (IVIG) alternating with anti-D immune globulin, but laparoscopic splenectomy was indicated at 20 weeks' gestation because of thrombocytopenia. Following surgery, she continued prednisone and intermittent IVIG therapy until spontaneous delivery at 34 weeks' gestation. A small accessory spleen was identified postpartum by nuclear medicine scan. Satisfactory platelet concentrations were maintained postpartum using danazol and predisone. Conclusion: Laparoscopic splenectomy is a therapeutic option for women with ITP during pregnancy that fails to respond to medical management.

引用

页码：771 / 774

页数：4

共 20 条

[1] Safety and risks of laparoscopy in pregnancy [J].

Al-Fozan, H ;

Tulandi, T .

CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, 2002, 14 (04) :375-379

[2]

Allran CF, 2002, LAPAROENDOSC ADV S A, V12, P445

[3]

Anglin B V, 2001, JSLS, V5, P63

[4] COMPLICATION OF LAPAROSCOPY DURING EARLY-PREGNANCY [J].

BARNETT, MB ;

LIU, DTY .

BRITISH MEDICAL JOURNAL, 1974, 1 (5903) :328-3286

[5] Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus:: a prospective study of 103 pregnancies [J].

Cortés-Hernández, J ;

Ordi-Ros, J ;

Paredes, F ;

Casellas, M ;

Castillo, F ;

Vilardell-Tarres, M .

RHEUMATOLOGY, 2002, 41 (06) :643-650

[6] Intraabdominal carbon dioxide insufflation in the pregnant ewe - Uterine blood flow, intraamniotic pressure, and cardiopulmonary effects [J].

Cruz, AM ;

Southerland, LC ;

Duke, T ;

Townsend, HGG ;

Ferguson, JG ;

Crone, LAL .

ANESTHESIOLOGY, 1996, 85 (06) :1395-1402

[7] Effects of CO2 pneumoperitoneum in pregnant ewes [J].

Curet, MJ ;

Vogt, DA ;

Schob, O ;

Qualls, C ;

Izquierdo, LA ;

Zucker, KA .

JOURNAL OF SURGICAL RESEARCH, 1996, 63 (01) :339-344

[8] LAPAROSCOPIC SPLENECTOMY [J].

DELAITRE, B ;

MAIGNIEN, B ;

ICARD, P .

BRITISH JOURNAL OF SURGERY, 1992, 79 (12) :1334-1334

[9] Pneumoamnion and pregnancy loss after second-trimester laparoscopic surgery [J].

Friedman, JD ;

Ramsey, PS ;

Ramin, KD ;

Berry, C .

OBSTETRICS AND GYNECOLOGY, 2002, 99 (03) :512-513

[10]

Gabbe SG, 2002, OBSTET NORMAL PROBLE, P1170

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