Maternal and fetal outcome of pregnant women with idiopathic thrombocytopenic purpura: retrospective analysis of 25 pregnancies.

The optimal management of pregnant women with idiopathic thrombocytopenic purpura (ITP) is controversial. We reviewed our experience with 25 pregnancies in 19 women with ITP over a 14-year period. The incidences of bleeding during pregnancy and postpartum hemorrhage were 12.0% and 24.0%, respectively, in our series. No maternal mortality was noted. Thirteen infants were born by vaginal delivery and 12 by cesarean section. Moderate to severe neonatal thrombocytopenia (platelet count < 100 x 10(9)/L) was diagnosed in six newborns. One of them had intracranial hemorrhage complicated by a bilateral sensorineural hearing loss. ITP mothers with a prenatal platelet count < 30 x 10(9)/L and a platelet count < 100 x 10(9)/L at delivery had a higher risk of giving birth to infants with moderate to severe neonatal thrombocytopenia. Cesarean section may improve the outcome of these fetuses.