[Idiopathic autoimmune thrombopenic purpura and pregnancy]

Immune thrombocytopenic purpura can no longer be considered as incompatible with pregnancy provided that close surveillance is undertaken. However, the main risk (a possible intracranial hemorrhage) persists in the newborn when severe thrombocytopenia due to the placental transfer of maternal IgG has occurred. None of the maternal parameters is predictive of the fetal thrombocytopenia or of its magnitude. A platelet count on fetal blood obtained by in utero or scalp sampling allows the choice between vaginal delivery or cesarean section, to limit the risk of intracranial bleeding. In most cases i.v. IgG infusion allows rapid correction of severe thrombocytopenia in the newborn.