title: Immune thrombocytopenic purpura in pregnancy: a reappraisal of obstetric management and outcome.
abstract: OBJECTIVE
  To evaluate the complications of pregnancy and perinatal outcome in women with idiopathic thrombocytopenic purpura (ITP).
  
  
  METHODS
  A retrospective analysis of 38 singleton pregnancies, their course, obstetric management and perinatal outcome of 32 patients with known ITP was undertaken.
  
  
  RESULTS
  No major antenatal complications were noted among the patients. There were no maternal deaths, and only 1 stillbirth occurred in the series. Fourteen infants were delivered by cesarean section and 24 by vaginal delivery. Neonatal cord blood platelet count was performed in each of the live-born infants and revealed thrombocytopenia in 16 infants, but in only 6 (16.2%) of them was the cord blood platelet count < 50 x 10(9)/L. There was no neonatal death in the study, although 6 infants required supportive treatment with corticosteroids and intravenous immunoglobulin G. No maternal features could be used to predict the neonatal platelet count at birth. These results are comparable with other studies in the recent literature.
  
  
  CONCLUSIONS
  Due to the low incidence of poor neonatal outcome in mothers with ITP, obstetric intervention based solely on their platelet count is not justified. Every patient with ITP should be managed individually, and the routine use of cesarean section should be abandoned.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, Dammam University and King Fahad University Hospital, Al Khobar, Saudi Arabia. sabdkader@hotmail.com
authors.forename: Turki
authors.initials: T
authors.lastname: Gasim
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005312:Fetal Blood / Q000166:cytology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007231:Infant, Newborn; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D011256:Pregnancy Outcome; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous