Pregnancy of patients with idiopathic thrombocytopenic purpura: maternal and neonatal outcomes

Abstract

Objective: Thrombocytopenia occurs in 7% of pregnant women. Along with other causes, idiopathic thrombocytopenic purpura (ITP), which isan autoimmune disease with autoantibodies causing platelet destruction, must be considered in the differential diagnosis. Antiplatelet antibodiescan cross the placenta and cause thrombocytopenia in the newborn. The aim of our study was to assess the management of ITP in pregnancy,and to investigate neonatal outcomes.Material and Methods: This retrospective study was conducted in a tertiary center including 89 pregnant patients with ITP followed betweenOctober 2011 and January 2018. Patients were evaluated in two groups according to diagnoses of ITP and chronic ITP. Age, obstetric history, ITPdiagnosis, and follow-up period, presence of splenectomy, platelet count during pregnancy and after birth, treatment during pregnancy, route ofdelivery, weight and platelet count of newborn, sign of hemorrhage, and fetal congenital anomaly were assessed.Results: Considering the ITP and chronic ITP groups, no significant difference was seen with respect to parity, timing of delivery, preoperativeand postoperative platelet counts, and hemoglobin values. Route of delivery, birth weight, APGAR scores, newborn platelet count, and congenitalanomaly rates were also similar. The timing of treatment was different because patients whose diagnoses were established during pregnancywere mostly treated for preparation of delivery. Treatment modalities were similar.Conclusion: Probability of severe thrombocytopenia at delivery is higher in patients with ITP who are diagnosed during pregnancy whencompared with patients who received prepregnancy diagnoses. ITP is an important disease for both the mother and newborn. Patients shouldbe followed closely in cooperation with the hematology department. (J Turk Ger Gynecol Assoc 2020; 21: 97-101)