Chronic idiopathic thrombocytopenic purpura: a case report

Abstract

Aim: The aim of the study was to present the management of a case with chronic immune thrombocytopenic purpura (ITP) during pregnancy and the management of the delivery. Case: A 34 years old pregnant women with thrombocytopenia who was found at 6 th week of gestation. Thrombocyte count decreased to 23000/~ level at 14 week of gestation. After the hematology consultation, oral prednisolone 48mg/day was initiated and continued until the delivery. Despite the prednisolone administration, thrombocyte count was 30000/~ at 39 week of gestation, cesarean delivery was planned. Patient received lunite thrombocyte apheresis before the operation and during the operation. During caesarean section the postoperative period, no maternal and neonatal complications occured. Conclusion: ITP in both the mother and the baby can cause severe hematologic sequelae of a disease with a potential and significant thrombocytopenia. The first drug in treatment of ITP is steroids. Many researchers suggest cesarean delivery to protect fetal intracranial hemorrhage.

Özet

Ama~: Kronik immun trombositopenisi olan hastanm gebelikte ve dogumda tedavi yakla§zmz Olgu: 34 ya§mda hastanm gebeliginin 6.ha.ftasmda trombositopeni fark edildi ve takipler szrasmda 14. ha.ftada trombosit sayzsz 23000/~ olarak tespit edildi. Hematoloji konsultasyonunu takiben hastaya gunlilk 48 mg oral prednisolone doguma kadar kullamlmak uzere ba§landz. Prednisolon tedavisine ragmen 39. gebelik ha.ftasmda trombosit sayzsz 30000/~ olarak bulundu ve planh sezeryanla doguma karar verildi. 39. gebelik haftasmda hastaya operasyon oncesi ve operasyon szrasmda hirer unite olmak uzere top/am 2 unite trombosit aferezi verildi. Postoperatif ve operatif surec;te annede ve bebekte herhangi bir komplikasyon geli§medi. Sonu~: Kronik iTP hem annede hem de fetusta ciddi hematolojik sekele neden olabilen ve belirgin trombositopeniye yola ac;abilen bir hastahktzr. Kronik iTP ic;in ilk ilac; kotikosteroid tedavisidir. Birc;ok ara§tlrmacz fetal intrakranial kanamadan korunmak ic;in sezeryanla dogumu onermektedirler.