Thrombocytopenia is hematologic disorder commonly occurs during pregnancy (5%) with different severity. It doesn't cause severe problem during pregnancy and after the delivery if it is not below certain level which will cause spontaneous bleeding. But in this case, patient was previous cesarean section status and platelet number didn't arise more than 20,000/microliter even after transfusion which will cause spontaneous bleeding. Vaginal delivery was done because transverse cesarean section was considered relatively safe although there was the risk of rupture of uterus, and was successful-both mother and baby is in good health condition. Here now we report this case because vaginal delivery of Immunologic thrombocytopenic purpuric woman with prior history of cesarean section has not reported.
Cesarean Section ; Female ; Hemorrhage ; Humans ; Mothers ; Platelet Count ; Pregnancy ; Rupture ; Thrombocytopenia ; Uterus

OBJECTIVE: Abnormalities of liver-related indices are common in ICU patients, but the effects of cholestasis and hypoxic hepatitis in critically ill patients remains unclarified. The purpose of this study was to investigate the effects of cholestasis and hypoxic liver dysfunction on the prognosis of ICU patients. METHODS: A retrospective study was conducted based on the data of patients admitted to the ICU for the first time between 2001 and 2011 archived in the MIMIC-Ⅲ database. The patients were divided into cholestasis, hypoxic hepatitis and control groups, and their 28-day case fatality rate as the primary outcome was compared among the groups. RESULTS: A total of 5852 ICU patients were included in the analysis. The incidence of cholestasis and hypoxic liver dysfunction was 31.9% (1869/5852) and 17.9% (1046/5852), respectively. There was no significant difference in 28-day case fatality rate between cholestasis group and the control group. Compared with the control group, the patients with hypoxic hepatitis had a significantly higher 28-day case fatality rate (46% 35%, < 0.01), a higher hospital case fatality rate (40% 31%, < 0.01), and a higher ICU case fatality rate (35.7% 22.2%, < 0.01). Logistic regression analysis showed that lactic acid (LAC), aspartate transaminase (AST), and international standard ratio (INR) were independent risk factors for 28-day case fatality rate. CONCLUSIONS The incidence of cholestatic liver dysfunction is higher than that of hypoxic hepatitis, but it does not increase the 28-day case fatality rate of the ICU patients, suggesting that cholestatic liver dysfunction may be the early adaptation of the liver to critical diseases.
Cholestasis ; Hepatitis ; Humans ; Intensive Care Units ; Prognosis ; Retrospective Studies