[Human immunodeficiency virus (HIV), thrombopenia and pregnancy]

Abstract

Three cases of thrombocytopenia in pregnant women are described. Two of these patients had an AIDS-like illness and the third one had AIDS. This HIV-associated change occurred in 8% of the complications of a consecutive series of 38 pregnant women who were positive for the HIV antibody test in the course of one year. A link with HIV was established after eliminating idiopathic pregnancy thrombocytopenic purpura and after eliminating every other viral cause for the thrombocytopenia. The normal myelogram speaks in favour of a peripheral origin for the platelet destruction. Treatment consisted in administering immunoglobulins intravenously in a continuous transfusion in doses of 0.04 g/kg per day. The method was effective in two cases. Three cesareans were carried out. In two cases the recovery was uncomplicated and in the third case the haemorrhagic syndrome developed immediately after delivery. This patient died 35 days after delivery. Fetal scalp blood or fetal cord blood could not be taken in any of these three cases. The newborn did not have thrombocytopenia at birth, but they did have anti-IVF antibodies and one of them developed and AIDS-like syndrome. The time interval has not been long enough to assess the further development in the two other cases. The survivors are being followed up with a threefold assessment of the blood picture, the immunological state and the virology. This is being done on the two surviving mothers and the three infants.