Maternal and Fetal Outcomes of Pregnancy in Patients with Immune Thrombocytopenia

摘要

Introduction:Immune thrombocytopenia (ITP) complicates 1-2 cases/10,000 pregnancies in India. Management of these patients is a challenge as it is associated with potential risks of maternal bleeding episodes and neonatal alloimmune thrombocytopenia (NAITP).Objective:To study the maternal and fetal/neonatal outcome of pregnancy in Indian patients with ITP and identify the risk factors for NAITP.Materials and Methods:In this retrospective study, all ITP patients with pregnancy who were diagnosed and treated at our center over 8 years (August 2010- August 2018) were evaluated for their hematological, obstetrical, and fetal outcomes.Results:Twenty-nine pregnancies in 27 ITP patients were studied. The mean interval between the diagnosis of ITP and each pregnancy was 29 ± 14.9 months. The mean baseline platelet count was 0.18 ± 0.05 X 10 9 /L. Twenty-seven (93.1) cases were treated with oral prednisolone. Twenty deliveries (69.0) were vaginal and 9 (31.0) deliveries were by cesarean section. There were no major bleeding episodes during pregnancy or delivery.The mean neonatal platelet count was 1.23 ± 0.58 × 10 9 /L at birth. NAITP was seen in 3 (3.5) neonates. No bleeds or intracranial hemorrhages were observed. Only maternal platelet count  50 X 10 9 /L at delivery showed a statistical correlation with NAITP (p = 0.022). There was no positive correlation between NAITP and the duration of maternal ITP, the timing of ITP onset, or type of treatment.Conclusion:Successful outcome of pregnancies in ITP patients is possible, and the risk of maternal bleeding and NAITP is low.© Federation of Obstetric Gynecological Societies of India 2020.