Amanda M Baucom1, Jeffrey A Kuller2, Sarah Dotters-Katz3. 1. Medical Student, East Carolina University, Greenville, NC. 2. Professor. 3. Assistant Professor, Division of Maternal Fetal Medicine, Duke University, Durham, NC.
Abstract
IMPORTANCE: Immune thrombocytopenia purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and nonpregnant patients. Although thrombocytopenia in pregnancy can be caused by more common pathologies such as gestational thrombocytopenia and preeclampsia, ITP can present initially during pregnancy, further complicating diagnosis. Management must be considerate of both the pregnancy itself and the fetus. OBJECTIVE: Review the diagnosis, treatment, and management of ITP in pregnancy based on current recommendations. EVIDENCE ACQUISITION: Review articles, original research, and case studies were utilized. RESULTS: Throughout pregnancy, patients are screened for a variety of conditions or disorders of pregnancy. Thrombocytopenia is a common pathology of pregnancy, but ITP is a rare condition that a provider needs to be aware of. After ruling out secondary causes of thrombocytopenia or more common causes such as gestational thrombocytopenia or preeclampsia, ITP should be considered. After diagnosis, treatment options should be discussed and initiated to provide safety for both the mother and fetus. CONCLUSIONS: After reading this article, the reader will understand the current recommendations regarding the diagnosis, treatment, and management of ITP in pregnancy. RELEVANCE: The practitioner will be comfortable treating this condition during pregnancy.
IMPORTANCE: Immune thrombocytopenia purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and nonpregnant patients. Although thrombocytopenia in pregnancy can be caused by more common pathologies such as gestational thrombocytopenia and preeclampsia, ITP can present initially during pregnancy, further complicating diagnosis. Management must be considerate of both the pregnancy itself and the fetus. OBJECTIVE: Review the diagnosis, treatment, and management of ITP in pregnancy based on current recommendations. EVIDENCE ACQUISITION: Review articles, original research, and case studies were utilized. RESULTS: Throughout pregnancy, patients are screened for a variety of conditions or disorders of pregnancy. Thrombocytopenia is a common pathology of pregnancy, but ITP is a rare condition that a provider needs to be aware of. After ruling out secondary causes of thrombocytopenia or more common causes such as gestational thrombocytopenia or preeclampsia, ITP should be considered. After diagnosis, treatment options should be discussed and initiated to provide safety for both the mother and fetus. CONCLUSIONS: After reading this article, the reader will understand the current recommendations regarding the diagnosis, treatment, and management of ITP in pregnancy. RELEVANCE: The practitioner will be comfortable treating this condition during pregnancy.