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March 6, 1978

Benign Parturient Purpura

Author Affiliations

University of Tennessee Center for Health Sciences Memphis

JAMA. 1978;239(10):930. doi:10.1001/jama.1978.03280370026015

To the Editor. —  A petechial eruption in an obstetric patient is regarded as a serious sign requiring immediate investigation. Perhaps most ominous is the presence of petechiae in the skin that may herald the development of disseminated intravascular coagulation (DIC). Since 50% of persons with DIC are obstetric patients,1 the concern of obstetricians for a petechial eruption is understood, especially when it obtains in a preeclamptic patient. Furthermore, in approximately 50% of cases of DIC, cutaneous lesions are the presenting sign.2However, a more common petechial rash is also seen in obstetric patients. We have often seen it in patients with mild preeclampsia, and it usually occurs in patients who vigorously "pushed" during the second stage of labor (Valsalva maneuvers that augment the expulsive forces of the uterus in the descent and birth of the fetal head).Benign parturient purpura (BPP) is suggested by a triad of