ITP in Pregnancy


  • 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 hypertension
  • microangiopathic hemolytic anemia
  • hereditary
  • thrombocytopenias


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


  • 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