Haema 2010; 1(2): 157-162
by Charis Matsouka, Athanasia Stamelou, Eystathios Koulieris
Haematology Department, Alexandras General Hospital, Athens, Greece
Abstract
Idiopathic thrombocytopenic purpura (ITP) is a complicated clinical problem for the management of which close cooperation between the haematologist, obstetrician and the paediatrician is required. Both, diagnosis and treatment during pregnancy pose difficulties to the physician. The differential diagnosis includes diseases that cause thrombocytopenia in non pregnant population as well as conditions associated with thrombocytopenia during pregnancy. When medical intervention is necessary, corticosteroids and IVIg are the first-line treatments. Dealing with ITP in pregnancy becomes particularly intractable when the disease is resistant to first-line therapy and splenectomy is considered. Regarding the fetus-neonate there are not reliable markers that can predict the probability or the depth of thrombocytopenia and the risk of intracranial bleeding, therefore close monitoring of platelet counts of the neonate is required.