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Questions and Answers
What is the platelet count cutoff for defining neonatal thrombocytopenia?
Which infection is the most common cause of congenital thrombocytopenia?
In neonates, what is the characteristic feature of thrombocytopenia caused by TORCH infections?
Which drug exposure during pregnancy is associated with neonatal thrombocytopenia?
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What percentage of infants with congenital toxoplasmosis develop thrombocytopenia?
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Which gene mutation can lead to inherited thrombocytopenias?
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What percentage of neonates have thrombocytopenia present at or within 72 hours of birth?
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Which syndrome is now rare in countries with organized immunization programs due to the prevention of maternal infection?
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What is the estimated prevalence of neonatal thrombocytopenia at birth?
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Which of the following drugs is NOT associated with in utero exposure leading to neonatal thrombocytopenia?
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Study Notes
Nonimmune Mechanisms of Platelet Destruction
- Nonimmune platelet destruction arises from interactions with nonendothelial surfaces, activation of coagulation, or platelet consumption due to endovascular injury.
- Coagulation factors may not be significantly depleted in these scenarios.
Thrombocytopenia in Pregnancy and Preeclampsia
- Incidental thrombocytopenia, also known as pregnancy-associated or gestational thrombocytopenia, is the leading cause of low platelet counts during pregnancy.
- About 5% of pregnant women experience mild thrombocytopenia with platelet counts between 100,000 and 150,000/μL; 98% have counts over 70,000/μL.
- Affected women typically have no prior low platelet history, maintain normal health, and do not face increased bleeding risks or risks for neonatal thrombocytopenia.
- Maternal platelet counts usually normalize within several weeks postpartum and may recur in future pregnancies.
Preeclampsia and Hypertensive Disorders
- Approximately 20% of pregnancy-related thrombocytopenia cases are linked to hypertensive disorders.
- Elevated platelet-associated immunoglobulin suggests immune factors may be involved in these cases.
- Low-dose aspirin may prevent preeclampsia in high-risk women, reducing the risk by about 15%.
Other Causes of Thrombocytopenia During Pregnancy
- Immune Thrombocytopenic Purpura (ITP) remains common in pregnant women, with symptoms unaffected by pregnancy.
- ITP should be considered in differential diagnoses for thrombocytopenia in pregnant patients.
- No significant correlation exists between maternal autoantibody levels and fetal platelet counts.
- Other conditions contributing to thrombocytopenia during pregnancy include HIV, systemic lupus erythematosus, antiphospholipid syndrome, Thrombotic Thrombocytopenic Purpura (TTP), and Hemolytic Uremic Syndrome (HUS).
- 10% to 25% of TTP cases manifest during pregnancy or postpartum, with recurrence likely in subsequent pregnancies.
- Plasmapheresis is the preferred treatment for TTP; without it, maternal mortality exceeds 90%.
Hemolytic Disease of the Newborn
- Moderate thrombocytopenia frequently occurs in infants affected by hemolytic disease of the newborn.
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Description
Test your knowledge on nonimmune mechanisms of platelet destruction and thrombocytopenia in pregnancy. Learn about the factors contributing to platelet destruction and thrombocytopenia occurrences during pregnancy.
