OBJECTIVE: Idiopathic thrombocytopenic purpura (ITP) frequently occurs in young women. Consequently, clinicians often give medical treatment to pregnant women who are diagnosed with ITP. This study might help to make a clinical guidelines for obstetrical ITP patients and their infants. METHODS: We retrospectively investigated the medical charts of 19 cases of deliveries and 22 neonates which from mothers with the diagnosis of ITP during pregnancy from March 1998 to March 2007. RESULT: Corticosteroid treatment was administrated in 13 cases, high-dose immunoglobulin therapy in 3 cases, and concentrated platelet transfusion in 17 cases during their antenatal care. Ten (45%) vaginal deliveries and twelve (55%) cesarean sections were performed. There were no obstetrical complications associated with their ITP and only four infants with platelet counts below the 150,000/micronLiter were reported after birth. However there were not any signs and symptoms of neonatal complications resulting from their maternal ITP. CONCLUSION : Our results demonstrate that mothers with ITP can successfully deliver healthy infants in most case. Although maternal and fetal bleeding may occur, such a fatal complication is uncommon.
Blood Platelets ; Cesarean Section ; Diagnosis ; Female ; Hemorrhage ; Humans ; Immunization, Passive ; Infant ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Transfusion ; Pregnancy* ; Pregnant Women ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*