ITP in Pregnancy

Background

- marked diff btwn maternal and fetal platelet counts

- no antenatal measures predict fetal status

- maternal response to medicine does not guarantee a favorable outcome for baby

- only previous neonatal outcomes provide predictor of neonatal platelet counts.

DDx

(low platelets during pregnancy)

-preg induced HTN

-HELLP

-microangiopathic hemolytic anemia

-hereditary

-thrombocytopenias

Diagnosis

- usually mild thrombocytopenia (>70k) and

- platelet count normalizes p delivery

Treatment

- most meds teratogenic or with pred- worsens gest diabtetes- so use

iv ig mostly

- baby with v low risk of ICH- but higher of normal baby.

- risk of ICH not change with cesarean

- if baby with platelets <30k, try iv ig and or prednisone

- exchange xfusion only if severe.

- no problem for breast feeding.

See Also

HEME: ITP

Source

6/06 MISTRY