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Maternal and fetal outcomes of primary immune thrombocytopenia during pregnancy: A retrospective study
1National Women's Health, Auckland City Hospital, New Zealand.
Objective:
We reviewed outcomes of 52 pregnancies in 45 women with immune thrombocytopenic purpura who delivered at Auckland Hospital with an antenatal platelet count of <100 × 109/L.
Outcome Measures:
Primary outcomes were maternal platelet count at delivery and treatment response. Secondary outcomes included post-partum haemorrhage (PPH).
Results:
Most women had thrombocytopenia at delivery. Treatment with prednisone was given in 14 (27%) pregnancies with responses considered safe for delivery in 11 pregnancies (79%). Women in eight pregnancies also received intravenous immunoglobulin; in five pregnancies (63%) a platelet response acceptable for delivery was achieved.Seventeen pregnancies (33%) were complicated by a PPH ≥500 mL. Ten pregnancies (19%) were complicated by a PPH ≥1000 mL. PPH was reported in all women with a platelet count <50 × 109/L at delivery.
Conclusions:
There were no antenatal bleeding complications but PPH was common among women with platelet counts <50 × 109/L at the time of birth.
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