Maternal and perinatal outcome in idiopathic thrombocytopenic purpura (ITP) with pregnancy.
BACKGROUND
Idiopathic thrombocytopenic purpura commonly affects women of childbearing age and is associated with maternal and fetal complications. Management of a pregnant patient is difficult and requires combined care of obstetrician and a neonatologist. We report our experience of idiopathic thrombocytopenic purpura during pregnancy during the last 7 years.


METHODS
A retrospective study over the 7-year period 1997-2003 was carried out in the Department of Obstetrics and Gynaecology in the Postgraduate Institute of Medical Education and Research, Chandigarh, India. The course of pregnancy, disease and perinatal outcome of 19 pregnancies in 16 patients with idiopathic thrombocytopenic purpura was studied.


RESULTS
Out of 16 patients with idiopathic thrombocytopenic purpura, eight were already diagnosed while the other eight were diagnosed during pregnancy. Five patients diagnosed during pregnancy had severe thrombocytopenia, and four of them showed hemorrhagic manifestation. Nine patients required steroids during pregnancy. Two patients received immunoglobulin therapy. During the antenatal period one patient developed pre-eclampsia and one patient had gestational diabetes mellitus. Both of these patients were on steroids. There was no postpartum hemorrhage or maternal death. None of the neonates had bleeding complication, irrespective of mode of delivery.


CONCLUSIONS
Pregnant patients with idiopathic thrombocytopenic purpura have generally good maternal and perinatal outcomes.
Suri
Vanita
V
Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. surivanita@yahoo.co.in
Aggarwal
Neelam
N
Saxena
Shilpi
S
Malhotra
Pankaj
P
Varma
Subhash
S
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007194:India; D007226:Infant Mortality; D007231:Infant, Newborn; D008428:Maternal Mortality; D018743:Perinatal Care / Q000592:standards*; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D012189:Retrospective Studies