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ITP and deliveryFrom: David McCoubrey (mccd@glen-net.ca)Tue May 21 21:16:41 1996
I currently have two patients in my practice at 28 weeks' gestation with ITP. These patients were both diagnosed during this index pregnancy with low platelet counts and platelet-associated IgG. They also have circulating antiplatelet antibodies. Both patients have no history of menorrhagia, bleeding, bruising, petechiae, etc. The old standard of therapy was to serially monitor fetal platelet counts by scalp sampling during labour and offer cesarean section if fetal counts were less than 80 000. In recent literature(Burrows, et al) in the NEJM their thinking was that fetal intracranial hemorrhage was nil in asymptomatic patients when they delivered vaginally. Any thoughts on similar experiences? Your comments would be appreciated. Dr. David R. McCoubrey mccd@glen-net.ca
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