Pregnancy outcome in patients with idiopathic thrombocytopenic purpura

Subbaiah, Murali; Kumar, Sunesh; Roy, Kallol Kumar; Sharma, Jai Bhagwan; Singh, Neeta

doi:10.1007/s00404-013-2958-x

Cited by 22 publications

(34 citation statements)

References 12 publications

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“…2,25,28,30 Our data are consistent with previous reports, in that severe thrombocytopenia occurred in 9% of all neonates, irrespective of maternal platelet counts, and 2 neonates experienced ICH. There were no other serious adverse effects observed, although nonsevere reactions may not have been well documented.…”

Section: Discussionsupporting

confidence: 82%

“…For instance, although mucocutaneous bleeding was excluded from the definition of bleeding in the current study unless transfusion or hospitalization was required, it was part of the definition of bleeding in 2 previously published studies. 2,25 Consistent with previous reports, 25,28 there were no neonatal deaths in this study, and fetal/neonatal outcomes were overall favorable and comparable whether their mothers were treated with IVIg or corticosteroids. In particular, the risk of preterm birth postulated in some reports for pregnancies with maternal antenatal prednisone exposure 29 was not apparent in our study, with no observed difference between the IVIg and corticosteroid groups in the rate of preterm birth below 37 or below 34 weeks' gestation.…”

Section: Discussionsupporting

confidence: 80%

“…In contrast to other studies, where 22% to 30% of pregnancies had moderate to severe bleeding, 2,25 no critical maternal bleeding events occurred in the current study, and antenatal bleeding was secondary to obstetrical complications. This difference is likely due to the variable definitions of bleeding adopted by studies.…”

Section: Discussioncontrasting

confidence: 50%

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Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy

Sun

Shehata

et al. 2016

Blood

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Key Points• Maternal platelet count response was not different for IVIg and corticosteroids in this retrospective study of pregnant women with ITP.• Neonatal outcomes were overall favorable and similar after treatment of maternal ITP with IVIg or corticosteroids.Treatment options for immune thrombocytopenia (ITP) in pregnancy are limited, and evidence to guide management decisions is lacking. This retrospective study of singleton pregnancies from 2 tertiary centers compared the effectiveness of intravenous immunoglobulin (IVIg) and corticosteroids in treatment of ITP. Data from 195 women who had 235 pregnancies were reviewed. Treatment was not required in 137 pregnancies (58%). Of the remaining 98 pregnancies in 91 women, 47 (48%) were treated with IVIg and 51 were treated with corticosteroids as the initial intervention. Mean maternal platelet count at birth did not differ between groups (IVIg 69 3 10 9 /L vs corticosteroids 77 3 10 9 /L; P 5 .71) nor did the proportion of mothers who achieved a platelet count response (IVIg 38% vs corticosteroids 39%; P 5 .85). There were no fatal or severe maternal, fetal, or neonatal hemorrhages. Of 203 neonates in whom platelet counts were available, 56 (28%) had a birth platelet count <150 3 10 9 /L and 18 (9%) had platelet counts <50 3 10 9 /L. Nadir platelet counts for most affected neonates occurred at birth, although for some neonates, nadir platelet counts occurred up to 6 days postnatally. Intracranial hemorrhage was noted in 2 neonates (nadir platelet counts were 135 and 18 3 10 9 /L). There were no neonatal deaths. The majority of pregnant women with a history of ITP did not require treatment, and neonatal outcomes were comparable for mothers who received IVIg or corticosteroids for treatment of maternal ITP. (Blood. 2016;128(10):1329-1335

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 80%

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Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy

Sun

Shehata

et al. 2016

Blood

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“…12,26,44 Pregnancy-associated autoimmune neonatal thrombocytopenia is a self-limited disease with a platelet nadir at postnatal days 4 and 5, after which most counts will rise to normal levels within 1 month. 25 In our study, neonatal thrombocytopenia was noted in 9 neonates.…”

Section: Discussionmentioning

confidence: 99%

A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy

Kong

Qin

Xiao

et al. 2017

Blood

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“…Classic ITP occurs in the second or third decade of life, [3] and complicates 1/1 000 -10 000 pregnancies. [12] In a report of 117 patients with TCP at term, Subbiah et al [14] found 41% of cases to be gestational and 26% to be due to ITP. However, this was a selected high-risk group and does not represent the general obstetric population.…”

Section: Discussionmentioning

confidence: 99%

Thrombocytopenia during pregnancy in women with HIV infection receiving no treatment

Sebitloane

2016

S Afr Med J

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Background. Thrombocytopenia (TCP) complicates 5 -8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a relatively high prevalence of TCP during pregnancy would be expected in a setting with a high antenatal seroprevalence of HIV. Methods. This was a sub-analysis of the data from a prospective trial in which the incidence of postpartum sepsis in HIV-infected women was compared with that in HIV-uninfected women. Women who were considered at low risk and eligible for vaginal delivery were recruited at 36 weeks' gestation, and followed up for 6 weeks after delivery. Full blood counts and CD4 counts of HIV-infected women were obtained at baseline and repeated 6 weeks after delivery. Results. The prevalence of TCP was 5.3% during pregnancy and 1.2% 6 weeks after delivery. The prevalence was similar among HIVinfected (6.0%) and HIV-uninfected women (4.7%) (p=0.292). Among the HIV-infected women, who were not receiving antiretroviral therapy (mean CD4 cell count of 453 cells/µL), there was no significant association between immunosuppression and the severity of TCP. Conclusions. Most of the TCP seen during pregnancy is of the gestational variety, and in this study HIV infection did not increase its prevalence or its severity.

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Pregnancy outcome in patients with idiopathic thrombocytopenic purpura

Abstract: Pregnancy outcome in patients with idiopathic thrombocytopenic purpura is generally good.

Cited by 22 publications

References 12 publications

Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy

Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy

A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy

Thrombocytopenia during pregnancy in women with HIV infection receiving no treatment

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