Maternal and fetal outcomes of primary immune thrombocytopenia during pregnancy: A retrospective study

We reviewed outcomes of 52 pregnancies in 45 women with immune thrombocytopenic purpura who delivered at Auckland Hospital with an antenatal platelet count of <100？×？109/L. Primary outcomes were maternal platelet count at delivery and treatment response. Secondary outcomes included post-partum haemorrhage (PPH). Most women had thrombocytopenia at delivery. Treatment with prednisone was given in 14 (27%) pregnancies with responses considered safe for delivery in 11 pregnancies (79%). Women in eight pregnancies also received intravenous immunoglobulin; in five pregnancies (63%) a platelet response acceptable for delivery was achieved. Seventeen pregnancies (33%) were complicated by a PPH ≥500？mL. Ten pregnancies (19%) were complicated by a PPH ≥1000？mL. PPH was reported in all women with a platelet count <50？×？109/L at delivery. There were no antenatal bleeding complications but PPH was common among women with platelet counts <50？×？109/L at the time of birth