scholarly journals UPDATE: Severe Primary ITP in Pregnancy Study

2014 ◽  
Vol 166 (5) ◽  
pp. 806-806 ◽  
Keyword(s):  
Itp In Pregnancy ◽  
In Pregnancy

scholarly journals Immune Thrombocytopenic Purpura in Pregnancy- A Prospective Observational Study in a Tertiary Care Centre

2019 ◽  
Vol 34 (1) ◽  
pp. 15-21
Author(s):  
Tabassum Parveen ◽  
Firoza Begum ◽  
Nahreen Akhter ◽  
Nigar Sultana ◽  
Khairun Nahar
Keyword(s):  
Platelet Count ◽  
High Risk ◽  
Observational Study ◽  
Immune Thrombocytopenic Purpura ◽  
Platelet Transfusion ◽  
Prospective Observational Study ◽  
Thrombocytopenic Purpura ◽  
Neonatal Thrombocytopenia ◽  
Itp In Pregnancy ◽  
In Pregnancy

Objectives: Immune thrombocytopenic purpura (ITP) in pregnancy necessitates management of two patients, the mother and the newborn. Complications like maternal bleeding, fetal and neonatal thrombocytopenia demands appropriate and timely therapy. This prospective observational study was designed to explore and summarize the current approach to the investigation, diagnosis, management and outcome of ITP in pregnancy. Materials and Methods: Women with ITP admitted in the Fetomaternal Medicine Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2009 -2017, were included in the study. Total number of high risk pregnancy during that period were 7704 among them 20 cases were pregnancy with Immune Thrombocytopenic Purpura (ITP). Patients were managed under joint supervision of the fetomaternal medicine specialist and the hematologist. Prednisolone was considered as a first line drug in management protocol. Platelet transfusion was considered if there were symptoms or count <20X109/L at any stage of pregnancy or <50 X109 / L in late pregnancy without symptoms. Platelet count of newborn was performed at birth and repeated on day four and count<150X109/L was considered as neonatal thrombocytopenia. Results: Frequency of ITP among high risk patients was found 2.5/1000 live birth, most were preexisting (75%). Almost all cases (95%) were treated with prednisolone. Commonest clinical presentations were gum bleeding (70 %) and purpuric rashes (60%). Though during pregnancy, severe thrombocytopenia (<50 X109/L) was found in 7 patients (35%) but none was at the time of delivery, as drugs and/or platelet transfusion was considered to make delivery process safe. Platelet transfusion needed in 77.7% cases in a range of 1-75 units. Primary PPH noted in 3 cases (17%), increased bleeding during surgery in 5 patients (33%) and one patient needed ICU support. Neonatal thrombocytopenia noted in 5 cases (28%). Though 2 of the neonates needed NICU admission but none needed platelet transfusion and all the babies were discharged healthy. Conclusion: This study documents that pregnancy with ITP need close monitoring, require agents to raise the platelet count and repeated platelet transfusion to maintain reasonable safe platelet count. There are chances of PPH, capillary oozing during surgery. However good outcome is possible for most women, fetus and neonates with appropriate and timely therapy. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 15-21

scholarly journals Are Tpo agonists an option for ITP in pregnancy?

Blood ◽  
2020 ◽  
Vol 136 (26) ◽  
pp. 2971-2972
Author(s):  
Howard A. Liebman
Keyword(s):  
Itp In Pregnancy ◽  
In Pregnancy

A retrospective 11-year analysis of obstetric patients with idiopathic thrombocytopenic purpura

Blood ◽  
2003 ◽  
Vol 102 (13) ◽  
pp. 4306-4311 ◽  
Author(s):  
Kathryn E. Webert ◽  
Richa Mittal ◽  
Christopher Sigouin ◽  
Nancy M. Heddle ◽  
John G. Kelton
Keyword(s):  
Platelet Count ◽  
Retrospective Study ◽  
Epidural Analgesia ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Vaginal Bleeding ◽  
Severe Bleeding ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Itp In Pregnancy ◽  
In Pregnancy

AbstractNumerous studies have examined the outcomes of infants born to mothers with idiopathic thrombocytopenic purpura (ITP). Fewer studies have discussed the morbidity of obstetric patients with ITP. We describe a retrospective study of 92 women with ITP during 119 pregnancies over an 11-year period. Most women had thrombocytopenia during pregnancy. At delivery, women in 98 pregnancies (89%) had platelet counts lower than 150 × 109/L; most had mild to moderate thrombocytopenia. For many, the pregnancy was uneventful; however, women had moderate to severe bleeding in 25 pregnancies (21.5%). Women in 37 pregnancies (31.1%) required treatment to increase platelet counts. During delivery, 44 women (37.3%) received epidural analgesia without complications, with most having a platelet count between 50 and 149 × 109/L. Most deliveries (82.4%) were vaginal. Bleeding was uncommon at delivery. Infant platelet counts at birth ranged from 12 to 436 × 109/L; 25.2% of infants had platelet counts lower than 150 × 109/L, and 9% had platelet counts lower than 50 × 109/L. Eighteen infants (14.6%) required treatment for hemostatic impairment. Two fetal deaths occurred. One was caused by hemorrhage. ITP in pregnancy carries a low risk, but mothers and infants may require therapy to raise their platelet counts. (Blood. 2003;102:4306-4311)

W257 NEW-ONSET IMMUNE THROMBOCYTOPENIC PURPURA (ITP) IN PREGNANCY

2012 ◽  
Vol 119 ◽  
pp. S788-S789
Author(s):  
J. Wahba ◽  
R. Jaspal ◽  
V. Tailor ◽  
N. Garg ◽  
K. Joash
Keyword(s):  
Immune Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura ◽  
Itp In Pregnancy ◽  
In Pregnancy ◽  
New Onset

scholarly journals Rituximab – A novel therapy for severe ITP in pregnancy: A case report

2018 ◽  
Vol 12 (4) ◽  
pp. 196-198 ◽  
Author(s):  
Fionan Donohoe ◽  
Mary Higgins ◽  
Shane Higgins ◽  
Fionnuala McAuliffe ◽  
Karen Murphy
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Case Reports ◽  
Limited Information ◽  
Novel Therapy ◽  
Thrombocytopenic Purpura ◽  
Minimal Data ◽  
Itp In Pregnancy ◽  
Safe Treatment Option ◽  
In Pregnancy

Background Rituximab is a novel second-line agent for the treatment of immune thrombocytopenic purpura. Minimal data exist on the use of rituximab in pregnancy. This case illustrates the successful treatment of severe immune thrombocytopenic purpura diagnosed in pregnancy, refractory to all other medical management. Case A 32-year-old nulliparous woman was diagnosed with severe immune thrombocytopenic purpura at the time of booking for antenatal care (platelet level of 13 × 109/L). Standard treatment failed to adequately increase her platelet count. Therapy with rituximab was instituted, and her platelet count rose to normal levels, without side effects, and remained at a normal level throughout the pregnancy. There were no maternal or neonatal ill-effects of rituximab therapy. Conclusion Rituximab is potentially a safe treatment option for the management of immune thrombocytopenic purpura in pregnancy with good maternal and neonatal outcome when conventional treatments have been unsuccessful. Research is limited to case reports, and therefore limited information currently exists to guide clinicians.

scholarly journals Pregnancy outcomes of mothers with immune thrombocytopenia

2020 ◽  
Vol 9 (11) ◽  
pp. 4535
Author(s):  
Shashikala Karanth ◽  
Christy Vijay ◽  
Chaitanya Harita ◽  
Jaya S. Mol
Keyword(s):  
Pregnancy Outcomes ◽  
Immune Thrombocytopenia ◽  
Post Partum ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Chronic Itp ◽  
Age Of Diagnosis ◽  
History Of ◽  
Itp In Pregnancy ◽  
In Pregnancy

Background: It has been proposed that, thrombocytopenia is the most common haematological abnormality in pregnancy after anaemia. The incidence of severe immune thrombocytopenia (ITP) in pregnancy has been difficult to report because of the rarity of the disease. Objectives were to determine the prevalence, pregnancy outcomes, treatment modalities of ITP mothers over five years in a tertiary health care hospital in South India.Methods: Our study was a retrospective record study, which looked into various aspects of obstetrical outcomes and complications in ITP mothers. Records of the in-patient medical record department (MRD) folders of patients with ITP who delivered at St. Johns Medical Hospital, Bangalore were studied.Results: We identified 53 patients with ITP with a mean age of 25.6+4.6 years, age of diagnosis of ITP at 21.1+5.9 years and gestational age of 36.2+3 weeks. In our study 17 (32%) were acute and 36 (67.1%) were chronic ITP. In our study 39.6% had history of at least one prior pregnancy loss. Patients with ITP at 35-37 weeks were induced with PGE1 (35.7%) in comparison to those with PGE2 (p≤0.001). Post-partum haemorrage (PPH) was seen in 7.5% of the pregnancies and all four were mothers with chronic ITP. Severe preeclampsia in ITP mothers was seen in 2 (66.7%).Conclusions: Chronic ITP in pregnancy poses more risks to mother and foetus as seen with the higher chance of PPH etc. Mothers with ITP should be screened antenatally as the chances of anomalies are high in the foetus. 

scholarly journals TPO for ITP in pregnancy

Blood ◽  
2017 ◽  
Vol 130 (9) ◽  
pp. 1073-1074 ◽  
Author(s):  
James B. Bussel ◽  
Eun-Ju Lee
Keyword(s):  
Itp In Pregnancy ◽  
In Pregnancy
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