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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

9 Issues per year


IMPACT FACTOR increased in 2015: 1.798
Rank 46 out of 120 in category Pediatrics in the 2015 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2014: 0.731
Source Normalized Impact per Paper (SNIP) 2014: 0.687
Impact per Publication (IPP) 2014: 1.483

Online
ISSN
1619-3997
See all formats and pricing
Volume 42, Issue 1 (Jan 2014)

Issues

Hepatitis C virus-associated thrombocytopenia in pregnancy: impact upon multidisciplinary care provision

Cathy Monteith
  • Department of Obstetrics, Rotunda Maternity Hospital, Dublin, Ireland
/ Fionnuala Ní Áinle
  • Department of Haematology, Rotunda Maternity Hospital, Dublin; Ireland and Mater Misericordiae Hospital, Dublin, Ireland
/ Sharon Cooley
  • Department of Obstetrics, Rotunda Maternity Hospital, Dublin, Ireland
/ John S. Lambert
  • Department of Infectious Diseases, Mater Misericordiae Hospital, Dublin, Ireland
/ Barry Kelleher
  • Department of Gastroenterology, Mater Misericordiae Hospital, Dublin, Ireland
/ Valerie Jackson
  • Department of Clinical Audit, Rotunda Maternity Hospital, Dublin, Ireland
/ Maeve Eogan
  • Corresponding author
  • Department of Obstetrics, Rotunda Maternity Hospital, Dublin, Ireland
  • Email:
Published Online: 2013-09-04 | DOI: https://doi.org/10.1515/jpm-2013-0080

Abstract

Objective: Recent studies have implicated hepatitis C virus (HCV) in the pathogenesis of immune thrombocytopenia. In pregnancy-associated immune thrombocytopenia, multidisciplinary management is required due to a potential for bleeding complications. We performed a retrospective review of HCV-infected pregnant women and age-matched controls who were not infected with HCV.

Methods: One hundred and six women with a HCV viral load were identified from 2009 to 2011.

Results: Thrombocytopenia was identified in 10.3% of HCV-infected pregnant women and 1.6% of age-matched controls (P<0.001). Mean platelet count during pregnancy was 120±23×109/L in HCV-infected women and at delivery was significantly lower in HCV-infected women than in controls (P=0.01). Despite the significant difference in platelet counts, there was no significant difference in estimated blood loss (EBL) at delivery. Regional anaesthesia was performed in 73% of thrombocytopenic HCV-infected women and no complications were recorded. There were no fetal bleeding complications.

Conclusion: In the first study to date to investigate the impact of HCV on maternal platelet count we demonstrated a significantly higher frequency of thrombocytopenia and a significantly lower platelet count in HCV-infected pregnant women compared with controls. Interestingly, thrombocytopenia had no detectable impact on EBL at delivery.

Keywords: Hepatitis; platelets; thrombocytopenia

References

  • [1]

    Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao F, Moyer LA, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341:556–62.

  • [2]

    Berkley EM, Leslie KK, Arora S, Qualls C, Dunkelberg JC. Chronic hepatitis C in pregnancy. Obstet Gynecol. 2008;112:304–10.

  • [3]

    Chiao EY, Engels EA, Kramer JR, Pietz K, Henderson L, Giordano TP, et al. Risk of immune thrombocytopenic purpura and autoimmune hemolytic anemia among 120 908 US veterans with hepatitis C virus infection. Arch Inter Med. 2009;169:357–63.

  • [4]

    Garcia-Suarez J, Burgaleta C, Hernanz N, Albarran F, Tobaruela P, Alvarez-Mon M. HCV-associated thrombocytopenia: clinical characteristics and platelet response after recombinant alpha2b-interferon therapy. Br J Haematol. 2000;110:98–103.

  • [5]

    Hamaia S, Li C, Allain JP. The dynamics of hepatitis C virus binding to platelets and 2 mononuclear cell lines. Blood. 2001;98:2293–300.

  • [6]

    Lambert J, Jackson V, Coulter- Smith S, Brennan M, Geary M, Kelleher TB, et al. Universal antenatal screening for hepatitis C. Ir Med J. 2013;106:136–9.

  • [7]

    Martyn F, Phelan O, O’Connell M. Hepatitis C: is there a case for universal screening in pregnancy? Ir Med J. 2011;104:144–6.

  • [8]

    Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. Br J Haematol. 2012;158:3–15.

  • [9]

    Rajan SK, Espina BM, Liebman HA. Hepatitis C virus-related thrombocytopenia: clinical and laboratory characteristics compared with chronic immune thrombocytopenic purpura. Br J Haematol. 2005;129:818–24.

  • [10]

    Zhang W, Nardi MA, Borkowsky W, Li Z, Karpatkin S. Role of molecular mimicry of hepatitis C virus protein with platelet GPIIIa in hepatitis C-related immunologic thrombocytopenia. Blood. 2009;113:4086–93. [Web of Science]

About the article

Corresponding author: Dr Maeve Eogan, Department of Obstetrics, Rotunda Maternity Hospital, Dublin 1, Ireland, E-mail:


Received: 2013-04-10

Accepted: 2013-07-22

Published Online: 2013-09-04

Published in Print: 2014-01-01


Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0080. Export Citation

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