What are the International Consensus Report recommendations for the treatment of immune thrombocytopenia (ITP) during delivery?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Recommendations for delivery of women with ITP include the following  [40]  ​:

  • Cordocentesis and fetal scalp blood sampling should be avoided in the management of the fetus/neonate of a mother with ITP in pregnancy.
  • Neonatal alloimmune thrombocytopenia should be excluded by parental testing if the neonate presents with severe thrombocytopenia.
  • The mode of delivery should be determined by obstetric indications, not by anticipation of the neonatal platelet count.
  • Procedures during labor that may be associated with increased hemorrhagic risk to the fetus should be avoided, specifically the use of fetal scalp electrodes, fetal blood sampling, ventouse delivery, and rotational forceps.
  • Previous splenectomy has been associated with worsening of maternal ITP in pregnancy and a higher risk for neonatal thrombocytopenia.
  • A mother with a previous newborn, thrombocytopenic or not, is likely to have a second baby with a similar platelet count.

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