妊娠合并特发性血小板减少性紫癜对母胎的影响及诊治

Impact of idiopathic thrombocytopenic purpura in pregnancy on the pregnant women and fetuses and its diagnosis and treatment

特发性血小板减少性紫癜(ITP)病因复杂,起病缓慢,因为临床表现与其他导致血小板减少的疾病类似,鉴别诊断困难,围产期处理较为棘手,如处理不当,可危及母胎生命。近年来,虽然对ITP的研究有了很大的进展,多个国家都制定了相应的指南及共识,但对于妊娠合并ITP的理想诊治策略仍存在一定争议。文章结合近年的文献着重介绍妊娠合并ITP的临床表现、对母胎的影响及其诊断、鉴别诊断和治疗进展。

The pathophysiology of ITP is complicated and the onset of ITP is progressing slowly. The clinical features of ITP are similar to those of the other diseases leading to thrombocytopenia, the differential diagnosis is often difficult. The treatment in the perinatal period is very important because if it is treated improperly, the mother and fetus will be endangered. In recent years,although the study of ITP has been greatly developed,and many countries have developed the guidelines and consensus on how to manage ITP, but there is still controversy about the ideal strategy of diagnosis and treatment of ITP in pregnancy. This paper focused on elaborating the clinical manifestations, the impact on the pregnant women and fetuses, diagnosis, differential diagnosis and the treatment progress of ITP in pregnancy by reviewing recent literatures.