The case of abdominal delivery in acute heteroimmune drug indused thrombocytopenia

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.

Keywords

pregnancy / methamizol sodium / thrombocytopenia

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RIGHTS & PERMISSIONS

Shirokov D.M., Bolotskikh V.M., Dzhanashia M.M., Eremeeva D.R., Korostelev Y.M., Vartanova I.V., Blinov A.E.