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ITP in Pregnancy
From WikEM
Contents
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
- Low platelets during pregnancy
Differential Diagnosis
- preg induced hypertension
- HELLP
- microangiopathic hemolytic anemia
- hereditary
- thrombocytopenias
Evaluation
- Usually mild thrombocytopenia (>70k)
- Platelet count normalizes after delivery
Management
- Most medications are teratogenic or worsens gestational diabetes (prednisone) so use iv IG mostly
- baby with v low risk of ICH- but higher of normal baby
- risk of ICH not change with cesarean
- if baby with platelets <30k, try iv ig and or prednisone
- exchange xfusion only if severe.
- no problem for breast feeding.
