View source for ITP in Pregnancy

''See also [[ITP]] main page or [[Immune thrombocytopenic purpura (peds)]] for pediatric patients.''
==Background==
*Marked diff between maternal and fetal platelet counts
*No antenatal measures predict fetal status
*Maternal response to medicine does not guarantee a favorable outcome for baby
*Only previous neonatal outcomes provide predictor of neonatal platelet counts.

==Clinical Features==
[[File:Purpura.jpg|thumb|Petechiae in a patient with ITP.]]
[[File:Petechia on the tongue.jpg|thumb|Petechiae on the tongue in a patient with ITP.]]
[[File:Petechia lower leg2.jpg|thumb|Petechiae on the lower leg in a patient with ITP.]]
[[File:PMC4192833 TODENTJ-8-164 F1.png|thumb|Unprovoked gingival bleeding as a presenting symptom in ITP.]]
*[[Thrombocytopenia]] during pregnancy
**[[Petechiae]]
**[[Epistaxis]]
**[[Gingival bleeding]]
**[[Vaginal Bleeding]]
**[[GI bleeding]]
**[[Intracranial hemorrhage]]

==Differential Diagnosis==
{{Thrombocytopenia}}

==Evaluation==
*Usually mild thrombocytopenia (>70k)
**Platelet count normalizes after delivery

==Management==
*Balance risk of thrombocytopenia (for mother and fetus/baby) vs potential teratogenesis from therapy
*Treatment indicated if<ref>Stavrou E, Mccrae KR. Immune thrombocytopenia in pregnancy. Hematol Oncol Clin North Am. 2009;23(6):1299-316.</ref>:
**Platelets <10,000
**Platelets <30,000 and bleeding or in 2nd or 3rd trimester
*Risk of [[prednisone]] or [[IVIG]] outweighed by benefits in above situations<ref>https://www.ouh.nhs.uk/patient-guide/leaflets/files/13880Pitp.pdf</ref>
*Infant has slightly increased risk of [[ICH]] with v low risk of ICH- but higher of normal baby
**role of cesarean in preventing ICH controversial
*If baby has platelets <30k; [[IVIG]] and or [[prednisone]]
*No contraindication to breastfeeding.

==See Also==
*[[ITP]]
*[[Pregnancy (Main)]]

==References==
<references/>

[[Category:Heme/Onc]]
[[Category:OBGYN]]