Management of idiopathic thrombocytopenic purpura during pregnancy

Management of idiopathic thrombocytopenic purpura (ITP) during pregnancy requires concern for both fetal and maternal morbidity and death. A review of 14 pregnancies revealed significant maternal morbidity but no maternal deaths. The perinatal mortality was 21%. Current recommendations for management include: corticosteroids, splenectomy if response is unsatisfactory, liberal use of platelet transfusion if surgical intervention is required in the face of significant thrombocytopenia, and careful observation of the newborn infant and treatment with corticosteroids and/or platelets if thrombocytopenia is severe.