Advertisement

Management of Pregnancy Complicated with Idiopathic Thrombocytopenic Purpura: A Review of 16 Cases

  • Takehiko Matsuyama
  • Katsuhiko Iwasaki
  • Akikazu Fujii
Conference paper

Abstract

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder related to the destruction, mostly in the spleen, of platelets coated with antibody which belongs, usually, to the IgG class. Normalization of platelet value after both acute and chronic ITP may occur spontaneously, but recovery by surgical or pharmaceutical treatment is preferred for several reasons. Primary goals are to decrease the production of antibodies or to modify the production of phago-cytosing macrophages quantitatively or qualitatively. The etiology of primary ITP is unknown, but it follows secondarily to various other diseases, especially viral infections. Since ITP is common in young women in their reproductive years, it does occasionally complicate pregnancy. On one hand, fertility is not affected by the disease [10], but on the other, the percentage of spontaneous abortions is reported to be relatively high, between 7% and 30% [1,5,10]. The course of ITP does not seem to be influenced by pregnancy [2,9,10], while perinatal mortality can be up to 20% [1,2,6–8]. According to several reports [1,2,6–8], obstetrical management of ITP during pregnancy should be attempted in order to increase maternal platelet count throughout the pregnancy thus bringing it to term and preventing complications during labor. Karpatkin et al. [6] demonstrated that steroids are effective in increasing maternal and fetal platelet value. Recently, Imbach et al. [3,4] introduced treatment with high-dose intravenous immunoglobulin.

Keywords

Systemic Lupus Erythematosus Platelet Count Fetal Death Idiopathic Thrombocytopenic Purpura Immune Thrombocytopenic Purpura 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Carloss H, Mc Millan R, Crosby W (1980) Management of pregnancy in women with immune thrombocytopenic purpura. JAMA 244: 2756PubMedCrossRefGoogle Scholar
  2. 2.
    Heys R (1966) Child bearing and idiopathic thrombocytopenic purpura. J Obstet Gynaecol Br Commonw 73: 205CrossRefGoogle Scholar
  3. 3.
    Imbach P, d’Apuzzo V, Hirt A, Rossi E, Vest M, Barandun S, Baumgartner C, Morell A, Schoni M, Wagner P (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet I: 1228CrossRefGoogle Scholar
  4. 4.
    Imbach P, Barandun S, Baumgartner C, Hirt A, Hofer H, Wagner P (1981) High-dose intravenous gammaglobulin therapy of refractory in particular idiopathic thrombocytopenia in childhood. Helv Paediatr Acta 44: 81Google Scholar
  5. 5.
    Jones W, Storey B, Norton G, Neische F (1974) Pregnancy complicated by acute idiopathic thrombocytopenic purpura. J Obstet Gynaecol Br Commonw 81: 330PubMedCrossRefGoogle Scholar
  6. 6.
    Karpatkin M, Porges R, Karpatkin S (1981) Platelet counts in infants of women with autoimmune thrombocytopenic purpura. N Engl J Med 305: 936PubMedCrossRefGoogle Scholar
  7. 7.
    Laros R, Sweet R (1973) Management of idiopathic thrombocytopenic purpura during pregnancy. Am J Obstet Gynecol 122: 182Google Scholar
  8. 8.
    Murray J, Major U, Harris R (1976) The management of the pregnant patient with idiopathic thrombocytopenic purpura. Am J Obstet Gynecol 126: 449PubMedGoogle Scholar
  9. 9.
    Robson HM, Davidson LSP (1950) Purpura in pregnancy with special reference to idiopathic thrombocytopenic purpura. Lancet II: 164CrossRefGoogle Scholar
  10. 10.
    Schenker J, Polishuk W (1968) Idiopathic thrombocytopenic purpura in pregnancy. Gynecologia 165: 271Google Scholar

Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Takehiko Matsuyama
    • 1
  • Katsuhiko Iwasaki
    • 1
  • Akikazu Fujii
    • 1
  1. 1.Department of Obstetrics and GynecologyTakai University School of MedicineBouseidai, Isehara, KanagawaJapan

Personalised recommendations