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Korean Journal of Obstetrics & Gynecology 2007;50(7):961-968.
Published online July 1, 2007.
Maternal and neonatal outcomes in pregnancies complicated with idiopathic thrombocytopenic purpura (ITP).
Yu Na Park, Sei Eun Kim, Kyung Lan Jung, Jung Ae Min, Suk Joo Choi, Soo Young Oh, Jong Hwa Kim, Cheong Rae Roh
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. crroh@smc.samsung.co.kr
To investigate the maternal and neonatal outcomes in pregnancies complicated with idiopathic thrombocypenic purpura (ITP) and to identify antenatal factors to predict the neonatal thrombocytopenia. METHODS: We analyzed retrospectively maternal and neonatal outcomes of the32 pregnant women with ITP who were delivered over a 12-year period. RESULTS: The prevalence incidence of ITP in pregnancy was 0.87 per 1,000 live births in this study population. The diagnosis of ITP was made more before pregnancy than with afterduring during pregnancy (63% vs 37%). Maternal platelet transfusion was done in 62.5 % of pregnancies with ITP. Sixty nine percent of pregnancies with ITP received medical therapies; steroid only in 8 cases (25%), steroid + IVIG (intravenous immunoglobulin) in 6 cases (18.7%), IVIG only in 2 cases (6.2%), and steroid + IVIG + anti-Rh (anti-D) in 1 case (3.1%). Overall response rate (Plt > 50 x 10(9)/L) to medical treatment was 77%. Neonatal thrombocytopenia (Plt < 50 x 10(9)/Ll) was observed seen in 4 cases (14.2%) immunoglobulin. There was no correlation between the maternal and the neonatal platelet count. Moreover medical treatment during pregnancy did not make any difference in neonatal platelet count. There was one case of neonatal ICH (germinal matrix hemorrhage). CONCLUSION: Although neonatal thrombocytopenia occurred in 140% of pregnancies with ITP, no antenatal factor could predict neonatal thrombocytopenia.
Key Words: Idiopathic thrombocytopenic purpura, Pregnancy, Management, Neonatal thrombocytopenia

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