ITP in Pregnancy: Difference between revisions

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==Treatment==
==Treatment==
*Most medications are teratogenic or worsens gestational diabetes (prednisone) so use iv IG mostly
*Most medications are teratogenic or worsens gestational diabetes (prednisone) so use iv IG mostly
* baby with v low risk of ICH- but higher of normal baby
*baby with v low risk of ICH- but higher of normal baby
* risk of ICH not change with cesarean
*risk of ICH not change with cesarean
* if baby with platelets <30k, try iv ig and or prednisone
*if baby with platelets <30k, try iv ig and or prednisone
* exchange xfusion only if severe.
*exchange xfusion only if severe.
* no problem for breast feeding.
*no problem for breast feeding.


==See Also==
==See Also==

Revision as of 23:07, 5 July 2016

Background

  • Marked diff between maternal and fetal platelet counts
  • No antenatal measures predict fetal status
  • Maternal response to medicine does not guarantee a favorable outcome for baby
  • Only previous neonatal outcomes provide predictor of neonatal platelet counts.

Clinical Features

  • Low platelets during pregnancy

Differential Diagnosis

  • preg induced HTN
  • HELLP
  • microangiopathic hemolytic anemia
  • hereditary
  • thrombocytopenias

Diagnosis

  • Usually mild thrombocytopenia (>70k)
    • Platelet count normalizes after delivery

Treatment

  • Most medications are teratogenic or worsens gestational diabetes (prednisone) so use iv IG mostly
  • baby with v low risk of ICH- but higher of normal baby
  • risk of ICH not change with cesarean
  • if baby with platelets <30k, try iv ig and or prednisone
  • exchange xfusion only if severe.
  • no problem for breast feeding.

See Also

References