Korean J Obstet Gynecol.  2007 Jul;50(7):961-968.

Maternal and neonatal outcomes in pregnancies complicated with idiopathic thrombocytopenic purpura (ITP)

Affiliations
  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. crroh@smc.samsung.co.kr

Abstract


OBJECTIVE
To investigate the maternal and neonatal outcomes in pregnancies complicated with idiopathic thrombocypenic purpura (ITP) and to identify antenatal factors to predict the neonatal thrombocytopenia.
METHODS
We analyzed retrospectively maternal and neonatal outcomes of the32 pregnant women with ITP who were delivered over a 12-year period.
RESULTS
The prevalence incidence of ITP in pregnancy was 0.87 per 1,000 live births in this study population. The diagnosis of ITP was made more before pregnancy than with afterduring during pregnancy (63% vs 37%). Maternal platelet transfusion was done in 62.5 % of pregnancies with ITP. Sixty nine percent of pregnancies with ITP received medical therapies; steroid only in 8 cases (25%), steroid + IVIG (intravenous immunoglobulin) in 6 cases (18.7%), IVIG only in 2 cases (6.2%), and steroid + IVIG + anti-Rh (anti-D) in 1 case (3.1%). Overall response rate (Plt > 50 x 10(9)/L) to medical treatment was 77%. Neonatal thrombocytopenia (Plt < 50 x 10(9)/Ll) was observed seen in 4 cases (14.2%) immunoglobulin. There was no correlation between the maternal and the neonatal platelet count. Moreover medical treatment during pregnancy did not make any difference in neonatal platelet count. There was one case of neonatal ICH (germinal matrix hemorrhage).
CONCLUSION
Although neonatal thrombocytopenia occurred in 140% of pregnancies with ITP, no antenatal factor could predict neonatal thrombocytopenia.

Keyword

Idiopathic thrombocytopenic purpura; Pregnancy; Management; Neonatal thrombocytopenia

MeSH Terms

Diagnosis
Female
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Incidence
Live Birth
Platelet Count
Platelet Transfusion
Pregnancy*
Pregnant Women
Prevalence
Purpura
Purpura, Thrombocytopenic, Idiopathic*
Retrospective Studies
Thrombocytopenia, Neonatal Alloimmune
Immunoglobulins
Immunoglobulins, Intravenous
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