Immune (Idiopathic) Thrombocytopenic Purpura Diagnosed in Pregnancy: A Case Report and Review of Management

Abstract

Immune (idiopathic) thrombocytopenic purpura (ITP) is an uncommon, but important cause of thrombocytopenia in pregnancy. It is a diagnosis of exclusion, and management should be based on a multidisciplinary care approach. ITP is characterized by moderate-to-severe thrombocytopenia commonly diagnosed in the first or early second trimester of pregnancy. The severity of thrombocytopenia has adverse implications on both maternal and fetal well-being. This paper is based on a case seen and managed in our institution and aims to discuss the various causes of thrombocytopenia and its implications in pregnancy as well as management of ITP in pregnancy based on current evidence and guidelines.

Immune (idiopathic) thrombocytopenic purpura with COVID-19 infection diagnosed in pregnancy and management: a case report

“…Upon diagnosis, the severity of thrombocytopenia should be ascertained, and platelet counts should be increased and stabilized to a safe level in pregnancy, especially during delivery and provision of epidural anesthesia. 3 Treatment should be instituted, if platelets fall to an unsafe low level or if the patient is symptomatic for The American Society of Hematology (ASH) and the British Committee for Standards in Hematology (BCSH) -General Hematology Task Force guidelines provide guidance to what is considered as a safe platelet level for delivery and procedures, as well as when to institute treatment. The ASH suggests a safe platelet count of at least 50×10 9 /l for both vaginal delivery and cesarean section.…”