The case of abdominal delivery in acute heteroimmune drug indused thrombocytopenia

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Abstract


The secondary gravida pregnant patient with uterine scar after previous cesarean section was treated with parenteral methamizol sodium due to renal colic and acute thrombocytopenia suddenly occurred. There were supposed that this condition had been drugs induced heteroimmune thrombocytopenia. The indications for planned cesarean section were breech presentation of large fetus in patient with uterine scar. However, uterine contractions appeared in 38/39 weeks and it was decided to deliver the patient urgently after appropriate preparing. The treating of severe thrombocytopenia was substitutive — thromboconcentrate and plasma transfusion and pathogenetic — using of dexamethasone and human immunoglobulin. After transfusion of one dose of thromboconcentrate and two doses of plasma the level of thrombocytes had reached of 21 × 109/л and it was decided to start cesarean section which was performed successfully in conditions of total combined anesthesia with tracheal intubation and pulmonary ventilation. The recovery of thrombocytes quantity occurred in postoperative period with continuing using of steroid therapy.


Dmitriy M. Shirokov

Author for correspondence.
dm_shirokov@interzet.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology; Saint Petersburg Pavlov State Medical University; Kirov Military Medical Academy
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089; 6G, Akademika Lebedeva street, Saint-Petersburg, 194044

MD. Head of the of Anesthesiology department

Vyacheslav M. Bolotskikh

docgin@yandex.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034

PhD Deputy director for medical work

Manana M. Dzhanashia

manana.ott@yandex.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034

MD. Head of Pregnancy Pathology Department No 2

Dina R. Eremeeva

dina-bikmullina@yandex.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034

MD. obstetrician-gynecologist of Pregnancy Pathology Department No 2

Yury M. Korostelev

juko_71@mail.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology; Saint Petersburg Pavlov State Medical University 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089

MD. anesthesiologist

Irina V. Vartanova

ivartanova@mail.ru
Ott Research Institute of Obstetrics, Gynecology and Reproductology; Saint Petersburg Pavlov State Medical University
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089

MD. anesthesiologist

Aleksey E. Blinov

79046408390@yandex.ru
Saint Petersburg Pavlov State Medical University
Russian Federation, 6/9, Lva Tolstogo street, St. Petersburg, 197089

internist anesthesiologist

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