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患者35岁,12岁时因慢性ITP行脾切除,以后周期性地行类固醇治疗。12年前和5年前两次妊娠,均予强的松治疗,但第二次妊娠期无效,分娩时血小板数低至24×10~9/L,女婴出生时即有皮肤淤斑、淤点、血小板亦有下降。第三次妊娠时,自3个月起虽予强的松治疗每日30mg,但血小板数仍低至50-60×10~9/L。预产期前9天入院时血小板数为40×10~9/L。给予多价完整的免疫球蛋白每日0.4g/kg,治疗5天,同时强的松减至10mg/天,治疗结束后4天,血小板数升至90×10~9/L,患者自然分娩,且不伴出血征象。男婴出生时血小板数120×10~9/L,也无出血,观察1个月,母、婴血小板基本正常。作者认为,大剂量免疫球蛋白不仅能使母体内血小板数增高,避免剖腹产,而
The patient, 35 years old, was splenectomized by chronic ITP at 12 years of age and was treated with steroids periodically thereafter. Twelve years ago and 5 years ago, two pregnancies were treated with prednisone, but the second gestation was invalid. The number of platelets during childbirth was as low as 24 × 10 ~ 9 / L. The baby was born with ecchymosis, Bruising point, platelets also decreased. On the third trimester, prednisone was administered 30 mg daily from 3 months, but the number of platelets remained as low as 50-60 x 10-9 / L. 9 days before the expected date of admission platelets 40 × 10 ~ 9 / L. Given polyvalent intact immunoglobulin 0.4g / kg daily for 5 days, at the same time prednisone reduced to 10mg / day, 4 days after the end of treatment, platelet count rose to 90 × 10 ~ 9 / L, patients with natural childbirth , And without signs of bleeding. Baby boy born number of platelets 120 × 10 ~ 9 / L, no bleeding, observed 1 month, mother, infant platelets were normal. The authors believe that high-dose immunoglobulin can not only increase the number of platelets in the mother, to avoid caesarean section, and