Outcomes of pregnancy in adult idiopathic thrombocytopenic purpura.

The outcomes of 39 pregnancies in 36 idiopathic thrombocytopenic purpura (ITP) patients were analysed. Among the 36 pregnant patients, 23 had active ITP (platelet count < 100,000 per mm3), 12 had inactive ITP, during pregnancies, while one patient had active and inactive ITP during each of her two pregnancies. Maternal bleeding during delivery occurred more commonly in thrombocytopenic patients and was more frequent by cesarean section than by vaginal delivery. There was a 56 per cent incidence of neonatal thrombocytopenia. Maternal platelet count had no predictive value for neonatal thrombocytopenia. There was no serious bleeding among neonates born from thrombocytopenic mothers. In our experience, vaginal delivery was a relatively safe procedure for delivering small neonates from multiparous ITP mothers. Cesarean section should be used to deliver relatively big neonates especially from primigravida ITP mothers and splenectomy should be done at the same time.