ROLE OF CORTICOSTEROIDS IN TREATMENT OF LOW-PLATELET DISEASES IN PREGNANT WOMEN
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Keywords
Thrombocytopenia, Pregnancy, Dexamethasone
Abstract
Background and Objectives : Assessment of pregnant women associated with thrombocytopenia( incidence – proposed risk factors – different causes of thrombocytopenia – maternal and neonatal complications) as it is an important disorder and considered a second haematological disorder during pregnancy after iron-deficiency anaemia . It is defined as aplatelet count below < 150,000/mm3 .This study compared two groups of participants to prove that dexamethasone is relatively safe and cost-effective in elevating of platelet count in Hellp syndrome.
Methods : This was a statistical descriptive study ,also experimental randomized controlled trial to investigate the role of dexamethasone in treatment , was conducted in the hospital of Obstetrics and Gynecology,Aleppo,Syria over 2 years.the participants were 600 women with thrombocytopenia, 210 of them who underwent dexamethasone and observation , platelet count was reassessed after 12-24-48 hours via CBC.
Results : incidence was 7.31%, different causes were: Gestational 58% - Hypertension-related diseases 23.5% - Idiopathic Thrombocytopenia Purpura 2,8% - Drugs 2.5% - Viral 2.2% - Bone Marrow Diseases 1.2% - Acute fatty Liver Of Pregnancy 0.5% - Heamolytic Ureamic Syndrome 0.3% - Antiphospholipid Antibodies Syndrome 0.3% - Systemic Lupus Syndrome 0.2%, Severity was: Mild 83.5% - Moderate 14.3% - Severe 2.2%,presence of risk factors: Hypertension 23.5% - Diabetes Mellitus 1.8% - Smoking 11.2% - Age 20-24 yrs 25.3% .Maternal Complications were: Blood 24.5%,Plasma 14.7%,Platelet 4% Transfusion – Labour Induction 1% - Placental Abruption 3.2% - Placental Previa 5.7% - Purpura 1.3% - Ecchymosis 2.2% - Vaginal Bleeding 17% - Drainage Bleeding 19.8% - Haematuria 1.2% - Dissaminated Intravascular Coagulation 1.3%. Fetal and Neonatal Complications: Apgar Scores at 1-5 minute less than 7 was 7.2%,2.2% , preterm Delivery 22.3% , Premature Rupture Of Membrane 2.2% , Neonatal Death 0.5% .It showed beneficial of dexamethasone in elevating platelet count accordin to cause of thrombocytopenia as it was safe and cost –effective in HELLP Syndrome and it did not benefit in bone marrow diseases.
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Dr Shirin Adnan Yousef
Gynecologist & Obestritian Gynecology Ward, Aleppo University hospital, Aleppo university, Syria
Dr Amal Hazzouri
Assistant professor, Gynecologist & Obestritian, Gynecology Ward, Aleppo University Hospital, Aleppo University, Syria
Dr Ashraf Olab
Professor, Gynecologist & Obesrition Gynecology Ward, Aleppo University Hospital, Aleppo University, Syria