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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Thrombocytopenia in pregnancy, a challenge in the intensive care unit (ICU)
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Vol. 66. Issue 7.
Pages 385-389 (August - September 2019)
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Vol. 66. Issue 7.
Pages 385-389 (August - September 2019)
Case report
Thrombocytopenia in pregnancy, a challenge in the intensive care unit (ICU)
Trombocitopenia en el embarazo, un desafío en la unidad de cuidados intensivos (UCI)
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M.I. Oliveira
Corresponding author
, V.S. da Costa, S. Mer, J. Osório, A.P. Martins
Departamento de Anestesiología, Unidad de Cuidados Intensivos (UCI), Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
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Table 1. Summary of blood tests performed.
Abstract

Thrombocytopenia is a common alteration during pregnancy, and the multiple possible etiologies make the differential diagnosis challenging. The physiological changes associated with pregnancy can mask severe conditions until they reach advanced stages. We report the case of a pregnant woman who presented fever and thrombocytopenia during labor. In the postpartum period she developed rapidly progressive hemodynamic instability requiring admission to the ICU. She also presented acute kidney injury, persistent thrombocytopenia, and platelet dysfunction. The differential diagnosis included DIC in the context of sepsis, PPH and other causes of thrombotic microangiopathies in pregnancy.

Keywords:
Thrombocytopenia
Sepsis
Postpartum hemorrhage
Disseminated intravascular coagulation
Thrombotic microangiopathies
Chorioamnionitis
Resumen

La trombocitopenia es una alteración común durante el embarazo, y las diversas etiologías posibles hacen que su diagnóstico diferencial sea un desafío. Los cambios fisiológicos en el embarazo pueden enmascarar la gravedad de la situación hasta etapas avanzadas. Este caso se refiere a una embarazada que presentó fiebre y trombocitopenia durante el parto. En el posparto desarrolló inestabilidad hemodinámica rápidamente progresiva, requiriendo ingreso en la UCI. Además, presentó lesión renal aguda, trombocitopenia y disfunción plaquetaria persistentes. El diagnóstico diferencial incluyó CID en el contexto de sepsis, HPP y otras causas de microangiopatías trombóticas en el embarazo.

Palabras clave:
Trombocitopenia
Sepsis
Hemorragia posparto
Coagulación intravascular diseminada
Microangiopatías trombóticas
Corioamnionitis

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