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Hamostaseologie 1986; 06(01): 9-16
DOI: 10.1055/s-0038-1655132
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Schattauer GmbH

Immunthrombozytopenien in der Schwangerschaft und beim Neugeborenen

W. Loos
1   Frauenklinik und -Poliklinik r. d. Isar der TU München (Direktor: Prof. Dr. H. Graeff)
,
R. v. Hugo
1   Frauenklinik und -Poliklinik r. d. Isar der TU München (Direktor: Prof. Dr. H. Graeff)
,
H. Graeff
1   Frauenklinik und -Poliklinik r. d. Isar der TU München (Direktor: Prof. Dr. H. Graeff)
› Author Affiliations
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Publication History

Publication Date:
25 June 2018 (online)

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Zusammenfassung

Immunthrombozytopenien beruhen auf einer durch Antikörper vermittelten Zerstörung der Plättchen. Sie sind häufig Ursache der Thrombozytopenie in der Schwangerschaft. Das bekannteste Krankheitsbild, die idiopathische thrombozytopenische Purpura (ITP), geht trotz Behandlung der Mutter häufig mit einer neonatalen Thrombozytopenie einher. Ein adäquates geburtshilfliches Management, das die Bestimmung mütterlicher Antikörper, die Thrombozytenzählung in der fetalen Kopfschwartenblutprobe, die Bereitstellung HLA; kompatibler Plättchenkonzentrate und die Immunglobulintherapie von Mutter und Kind einschließt, kann die perinatale Mortalität auf 0% bis 2% senken. Als differentialdiagnostische Ursachen kommen bei der Mutter die medikamentös-allergische Thrombozytopenie und die seltene posttransfusionelle Purpura in Frage, beim Neugeborenen die neonatale Alloimmunthrombozytopenie . Die Immunthrombozytopenien werfen eine vielschichtige hämatologische, geburtshilfliche und perinatologische Problematik auf. Das intensive geburtshilfliche Management und die weitere Behandlung sollten daher in Zentren erfolgen, die eine enge interdisziplinäre Zusammenarbeit zwischen Geburtshelfern, Hämatologen und Neonatologen gewährleisten.

 

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