MKSAP: 35-year-old woman with new-onset thrombocytopenia

A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks’ gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin. On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is normal, and there is no peripheral edema. Laboratory studies: Hematocrit 33% Hemoglobin 11.0 g/dL (110 g/L) Leukocyte count 9500/µL (9.5 × 109/L) Mean corpuscular volume 85 fL Platelet count 95,000/µL (95 × 109/L) Fibrinogen 350 mg/dL (3.5 g/dL) Alanine aminotransferase Normal Aspartate aminotransferase Normal Urinalysis Normal No schistocytes or platelet clumping is seen on the peripheral blood smear. Which of the following is the most appropriate management? A: Corticosteroids B: Emergent delivery of fetus C: Intravenous immune globulin D: Plasma exchange E: Repeat complete blood count in 1 to 2 weeks Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions OB/GYN Source Type: blogs