Idiopathic thrombocytopenia in pregnancy

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder in which antiplatelet autoantibodies bind to the antigens on platelet surfaces, resulting in their destruction. It is one of the most common autoimmune disorders that physicians manage today. Although it can present itself at any age, it tends to occur in young women. Hence, it commonly affects women in the childbearing age group. It is a haematological disorder for which diagnostic and treatment strategies are not well defined. In the past decade, there have been attempts for consensus in the management of patients with ITP, resulting in practice guidelines being published. The management of pregnant patients with ITP, however, has its special problems with the added responsibility of caring for 2 lives, the mother and her fetus. The choice of drugs is limited to those without teratogenic risks to the fetus and the overall aim is to prevent haemorrhage in both mother and fetus during the antenatal and peripartum periods. There are more data now to show that invasive procedures do not necessarily reduce fetal bleeding risk and are associated with more maternal morbidities, thus favouring the trend towards more conservative management.