ITP in Pregnancy

Background

1. marked diff btwn maternal and fetal platelet counts
2. no antenatal measures predict fetal status
3. maternal response to medicine does not guarantee a favorable outcome for baby
4. only previous neonatal outcomes provide predictor of neonatal platelet counts.

DDx

(low platelets during pregnancy)

1. preg induced HTN
2. HELLP
3. microangiopathic hemolytic anemia
4. hereditary
5. thrombocytopenias

Diagnosis

1. usually mild thrombocytopenia (>70k) and
2. platelet count normalizes p delivery

Treatment

1. most meds teratogenic or with pred- worsens gest diabtetes- so use iv ig mostly
2. baby with v low risk of ICH- but higher of normal baby.
3. risk of ICH not change with cesarean
4. if baby with platelets <30k, try iv ig and or prednisone
5. exchange xfusion only if severe.
6. no problem for breast feeding.

See Also

HEME: ITP

Source

6/06 MISTRY