Background:
Patients with the condition of idiopathic thrombocytopenic purpura (ITP) may present with, maternal and fetal hemorrhagic complications. Appropriate monitoring and treatment may be important in obstetric management.
Methods: A retrospective chart review was performed for obstetric patients with ITP at Bundang CHA hospital from March 1996 to March 2005.
Results:
Nineteen women with ITP delivered 22 children in 22 pregnancies. The median age at delivery was 30 years (range, 21∼37 years). The median platelet counts before pregnancy, during pregnancy, and at delivery were 44,000/ՌL (range, 20,000∼225,000/ՌL), 40,500/ՌL (range, 13,000∼335,000/ՌL), and 73,500/ՌL (range, 40,000∼308,000/ՌL. Treatment for ITP was done in 14 cases (63.6%) during pregnancy and in 18 cases (81.8%) at delivery. Platelet transfusion was done for one case during pregnancy but, was performed in 17 cases (77.3%) at delivery. Vaginal delivery was done in 10 cases (45%) and a Cesarean section was done in 12 cases (55%). No obstetric complications were observed. The median platelet count of 17 infants was 220,000/ՌL (range, 59,000∼315,000/ՌL). Four neonates were born with platelet counts below 150,000/ՌL. No infant showed any clinical signs of hemorrhage and there were not any neonatal complications.
Conclusion: In our study, obstetric patients with ITP and their neonates were safe with no hemorrhagic complication. However, when compared to the current guidelines, the treatment strategy used in the present study was excessive. Appropriate treatment according to the guidelines is necessary during the obstetric management of patients with ITP.

Keywords: Idiopathic thrombocytopenic purpura, Pregnancy, Thrombocytopenia