Management of Pregnancy Complicated with Idiopathic Thrombocytopenic Purpura: A Review of 16 Cases
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 , 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.  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.
KeywordsSystemic Lupus Erythematosus Platelet Count Fetal Death Idiopathic Thrombocytopenic Purpura Immune Thrombocytopenic Purpura
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