How is immune thrombocytopenia (ITP) managed during pregnancy and delivery?

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

Pregnant women require special consideration for delivery, as follows [18] :

  • If the platelet count is greater than 50 × 109/L (>50 × 103/µL), the risk of serious hemorrhage is low, but beginning oral prednisone a week before delivery is a reasonable precaution

  • If the platelet count is less than 50 × 109/L (50 × 103/µL) before delivery, treatment with oral prednisone and IVIG is recommended

  • Avoiding the use of IV RhIG in this situation until safety data are available is advisable

  • Rarely, splenectomy may be required to manage acute hemorrhage [19]

See Treatment and Medication for more detail.

For discussion of ITP in pregnancy, see Immune Thrombocytopenia and Pregnancy. For patient education information, see the Thrombocytopenia Directory


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