Pregnancy complicated by idiopathic thrombocytopenic purpura

Summary

The findings on 30 women with 48 pregnancies complicated by idiopathic thrombocytopenic purpura (ITP) have been analysed. The criteria for advising whether or not pregnancy complicated by ITP should be allowed to continue are as follows. When the onset of ITP precedes pregnancy and pregnancy occurs without any remission, termination of the pregnancy should be considered because in these circumstances ITP commonly runs a poor course. When the onset of ITP has preceded pregnancy, and is in remission at the time of conception, pregnancy can be continued. In those cases where ITP develops during pregnancy, it is generally possible to continue pregnancy.

Haemorrhage during pregnancy can be controlled with corticosteroids and blood transfusion. In those cases with decreased platelet counts, bleeding from the uterine cavity after labour is not a problem but haemorrhage from lacerated wounds is difficult to control. Therefore, vaginal delivery is preferred unless there is an absolute indication for caesarean section