International consensus report on the investigation and management of primary immune thrombocytopenia.

http://www.ouhsc.edu/platelets/////ITP/ITP%20Publications/pub2_1.pdf

Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology.

Background Invasive techniques such as amniocentesis and cordocentesis are used for diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization. The purpose of our study was to determine the value of noninvasive measurements of the velocity of blood flow in the fetal middle cerebral artery for the diagnosis of fetal anemia. Methods We measured the hemoglobin concentration in blood obtained by cordocentesis and also the peak velocity of systolic blood flow in the middle cerebral artery in 111 fetuses at risk for anemia due to maternal red-cell alloimmunization. Peak systolic velocity was measured by Doppler velocimetry. To identify the fetuses with anemia, the hemoglobin values of those at risk were compared with the values in 265 normal fetuses. Results Fetal hemoglobin concentrations increased with increasing gestational age in the 265 normal fetuses. Among the 111 fetuses at risk for anemia, 41 fetuses did not have anemia; 35 had mild anemia; 4 had moderate anemia; an...

Noninvasive Diagnosis by Doppler Ultrasonography of Fetal Anemia Due to Maternal Red-Cell Alloimmunization

Background—The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and manage...

/pdf/diagnosis-and-treatment-of-fetal-cardiac-disease-a-1komqhwbxf.pdf

Diagnosis and Treatment of Fetal Cardiac Disease A Scientific Statement From the American Heart Association

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by persistent thrombocytopenia (peripheral blood platelet count < 150 · 10 ⁄ l) due to autoantibody binding to platelet antigen(s) causing their premature destruction by the reticuloendothelial system, and in particular the spleen (Woods et al, 1984a,b). Although the basic underlying pathophysiology of ITP has been known for 50 years (Harrington et al, 1951), the literature shows that the investigation and management of patients with thrombocytopenia vary widely, and is not evidence-based, due to a lack of clinical trials and quality research. Despite major advances in our understanding of the molecular basis of many blood disorders, the diagnosis of ITP remains one of exclusion; there are currently no robust clinical or laboratory parameters that are able to establish the diagnosis of ITP with accuracy. This guideline aims to assess available diagnostic tests and therapies, and attempts to provide a rational approach to the diagnosis and treatment in adults, children and in pregnancy. Although natural history data are becoming available (Cohen et al, 2000; Djulbegovic & Cohen, 2001; Portielje et al, 2001), there are few randomized trials in ITP and many of the recommendations, like those of the American Society of Hematology (ASH) Panel (George et al, 1996), are based on expert opinion.

Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy

The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity.

Ultrasound in the diagnosis of congenital anomalies

Assessment of fetal kidney size in normal gestation by comparison of ratio of kidney circumference to abdominal circumference.

TRADITIONALLY, attempts to give transfusions to severely affected isoimmunized fetuses have involved the intraperitoneal injection of packed red cells.1 2 3 The success of this procedure depends on...

Peter Grannum

Papers

The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity.

Ultrasound in the diagnosis of congenital anomalies

Assessment of fetal kidney size in normal gestation by comparison of ratio of kidney circumference to abdominal circumference.

In Utero Exchange Transfusion by Direct Intravascular Injection in Severe Erythroblastosis Fetalis

Is routine cesarean section necessary for vertex-breech and vertex-transverse twin gestations?