Immunthrombozytopenie (ITP) und andere Thrombozytopenien in der Schwangerschaft

Zusammenfassung

Thrombozytopenien in der Schwangerschaft sind häufig. Bei isolierter, leichter Thrombozytopenie (100 000 – 150 000/µl) handelt es sich in der Regel um eine harmlose Gestationsthrombozytopenie. Bei Werten unter dieser Schwelle sollte eine Abklärung erfolgen, um Präeklampsie/HELLP-Syndrom, eine Immunthrombozytopenie (ITP) oder einige weitere seltene Ursachen nicht zu übersehen. In dieser Arbeit werden typische Symptome, Differenzialdiagnostik und therapeutisches Vorgehen für die tägliche Praxis dargestellt.

Abstract

Thrombocytopenia in pregnancy is common. Mildly decreased values (100 000 – 150 000/µl) are harmless and most often due to gestational thrombocytopenia. Values below this threshold require further workup because preeclampsia/HELLP syndrome, immune thrombocytopenia (ITP), and some other less common causes must not be missed. If the patient has ITP and needs treatment, corticosteroids or immunoglobulins will be offered. The risk of postpartum haemorrhage is relevant and the newborn may also develop transient thrombocytopenia. The care of the pregnant woman should be closely coordinated between gynaecologist, haematologist and paediatrician, if necessary, the patient must be referred to a centre with adequate experience. This paper outlines clinical presentation, differential diagnosis and therapy with focus on the approach in daily practice.

Schlüsselwörter Immunthrombozytopenie - Gestationsthrombozytopenie - Schwangerschaft

Key words immune thrombocytopenia - gestational thrombocytopenia - pregnancy

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