The obstetrical management of patients with immunologic thrombocytopenic purpura.

Pregnant women with immunologic thrombocytopenic purpura (ITP) run the risk of complications during pregnancy and labor, mainly due to the possibility of hemorrhage. Antibodies pass through the placenta, causing a transient, but dangerous thrombocytopenia in the fetus and infant. Four women with ITP, having five deliveries, are presented, showing that the modern treatment of these patients includes corticosteroids during pregnancy, thrombocyte transfusion during labor, and splenectomy being or after the pregnancy in selected cases. Cesarean section is not indicated for the disease per se, and fetal scalp blood sampling for thrombocyte count during labor is not necessary. The newborn needs immediate, careful control and, if necessary, thrombocyte transfusion and even steroids. Prolonged follow-up of the infants is necessary.