Management of Immune Thrombocytopenic Purpura in Pregnancy
- 1 March 2008
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrical & Gynecological Survey
- Vol. 63 (3), 182-188
- https://doi.org/10.1097/ogx.0b013e318164013c
Abstract
Chronic immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelet count and mucocutaneous bleeding. Pregnancy does not increase the incidence of ITP nor does it exacerbate a preexisting disease. Although pregnant women with ITP may experience several maternal and fetal complications, in most cases even with a very low platelet count, there is neither maternal nor fetal morbidity or mortality. Corticosteroids are the first line of therapy in pregnant women; intravenous immune globulin is commonly used in steroid resistant patients. Other treatments such as intravenously administered anti-D (Rhogam) and splenectomy during pregnancy have been reported. Antiplatelet IgG antibodies can cross the placenta and can induce fetal thrombocytopenia. In most women there is no indication to assess fetal platelet counts during the pregnancy. The mode of delivery is determined by obstetrical considerations.Keywords
This publication has 64 references indexed in Scilit:
- Systematic Review: Efficacy and Safety of Rituximab for Adults with Idiopathic Thrombocytopenic PurpuraAnnals of Internal Medicine, 2007
- Rituximab Is an Alternative to Splenectomy in Adults with Chronic Immune Thrombocytopenic Purpura: Results of a Multicenter Prospective Phase 2 Study.Blood, 2006
- Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITPBlood, 2004
- Idiopathic thrombocytopenic purpura complicating pregnancyBlood Reviews, 2002
- Immune Thrombocytopenic PurpuraNew England Journal of Medicine, 2002
- Management of idiopathic thrombocytopenic purpura in pregnancySeminars in Hematology, 2000
- A prospective study of protein‐specific assays used to investigate idiopathic thrombocytopenic purpuraBritish Journal of Haematology, 1999
- High-Dose Intravenous Immune Globulin and the Response to Splenectomy in Patients with Idiopathic Thrombocytopenic PurpuraNew England Journal of Medicine, 1997
- Longitudinal Analysis of Platelet Count and Volume in Normal PregnancyThrombosis and Haemostasis, 1997
- Fetal Thrombocytopenia and Its Relation to Maternal ThrombocytopeniaNew England Journal of Medicine, 1993