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

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 investigation of suspected ITP in pregnancy include the following98:

  • Patients with a history suggestive of ITP or those with a platelet count < 80 × 10 9/L should be investigated for possible ITP (Grade C recommendation).
  • As in nonpregnant patients, the diagnosis of ITP is one of exclusion using the patient’s history, physical examination, blood counts, and blood smear examination.
  • Laboratory evaluation is similar to the nonpregnant patient, but special consideration should be given to rule out hypertensive, microangiopathic, coagulopathic, and hepatic disorders associated with pregnancy. Recommended tests should be based on the clinical features and may include review of the blood smear, reticulocyte count, coagulation screen, liver function, thyroid function, ANAs, and antiphospholipid antibodies.
  • Bone marrow examination is not recommended unless atypical features are present.
  • Anti-platelet antibody testing does not predict the course of maternal or neonatal thrombocytopenia or distinguish ITP from gestational thrombocytopenia and is not recommended.
  • Testing of TPO levels is not recommended.

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