ITP in Pregnancy
Background
- marked diff btwn 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.
DDx
(low platelets during pregnancy)
-preg induced HTN
-HELLP
-microangiopathic hemolytic anemia
-hereditary
-thrombocytopenias
Diagnosis
- usually mild thrombocytopenia (>70k) and
- platelet count normalizes p delivery
Treatment
- most meds teratogenic or with pred- worsens gest diabtetes- 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
HEME: ITP
Source
6/06 MISTRY
