Korean J Intern Med.  2005 Jun;20(2):129-134. 10.3904/kjim.2005.20.2.129.

Clinical Aspects of Pregnancy and Delivery in Patients with Chronic Idiopathic Thrombocytopenic Purpura (ITP)

• Won YW
• Moon W
• Yun YS
• Oh HS
• Choi JH
• Lee YY
• Kim IS
• Choi IY
• Ahn MJ

• KMID: 1718034
• DOI: http://doi.org/10.3904/kjim.2005.20.2.129

Abstract

BACKGROUND
Idiopathic thrombocytopenic purpura (ITP) is a condition that often develops in young women and, consequently, physicians should frequently manage and monitor pregnant patients with this disorder. METHODS: We reviewed the charts of 30 women with chronic ITP delivered in 31 pregnancies from January 1995 to December 2003. RESULTS: Fifteen patients were diagnosed with ITP before pregnancy and sixteen patients were diagnosed during pregnancy. The mean platelet counts before pregnancy, during pregnancy, and at delivery were 70, 040/mm3, 83, 960/mm3, and 62, 680/mm3, respectively. The symptoms of hemostatic impairment were not noted in most of the pregnancies (77%, 24/31). During pregnancy and at delivery, most of the women (61%, 19/31) received various kinds of treatment to raise platelet counts. At delivery, the most commonly used therapy was platelet transfusion (48.4%, 15/31). Seven pregnancies (22.6%) were treated with corticosteroids during pregnancy and at delivery. Five pregnancies (16.1%) were treated with IV IgG during pregnancy and at delivery. Fifteen deliveries (51.7%) were performed by cesarean section and fourteen (48.3%) with vaginal delivery. Bleeding was uncommon at delivery. There were no cases of infants with any clinical signs of hemorrhage. CONCLUSION: Our current results suggest that ITP in pregnancy can proceed safely with low hemorrhagic risk in both infants and mothers, and that mothers with ITP can deliver healthy infants without serious hemorrhagic complications.

Keyword

Purpura; Thrombocytopenic; Idiopathic; Pregnancy; Delivery; Obstetric

MeSH Terms

Adult
Chronic Disease
Comparative Study
*Delivery, Obstetric/methods
Female
Glucocorticoids/therapeutic use
Humans
Immunoglobulin G/administration & dosage/therapeutic use
Immunoglobulins, Intravenous/therapeutic use
Infant, Newborn
Platelet Count
Platelet Transfusion
Pregnancy
*Pregnancy Complications, Hematologic/blood/diagnosis
*Pregnancy Outcome
*Purpura, Thrombocytopenic, Idiopathic/blood/diagnosis/therapy
Retrospective Studies