Retrospective analysis of maternal and fetal outcomes in pregnant women with chronic immune thrombocytopenic purpura

Abstract

Objective: In the present study, we investigated the demographic, clinical, laboratory, birth information, treatment method and maternal-fetal outcomes of pregnant patients who were diagnosed with chronic immune thrombocytopenic purpura. Methods: Hospital records of 24 women with the diagnosis of chronic immune thrombocytopenic purpura and their 26 pregnancies in the obstetrics department were retrospectively analyzed. Results: All the patients had immune trobositopenik purpura diagnosed before pregnancy. The mean age of the cases was 29.50±7.03 years (17-42), mean parity was 2.88±2.86 (0-10), mean gestational age was 36.00±3.40 weeks (27-39), respectively. The cases were admitted to our clinic with causes including the beginning of birth pains (65%), preterm labor (15%), premature rupture of membranes (4%), mort fetus (4%), headache (4%), abruptio placentae (4%), gestational hypertension (4%) and intrauterine growth restriction (4%). Although 15 (57.6%) patients were treated prednisolone during pregnancy, others did not receive any treatment. The mean platelet counts of patients before and after delivery were 62,226±38.04/mm 3 and 70,061±22.93/mm 3 , respectively. Ten cases (40%) with the mean platelet counts 28,240/mm 3 received treatments containing platelet apheresis, fresh frozen plasma, random platelets or combined treatments in order to increase the platelet count. Eleven cases (42%) were born vaginally and 15 (58%) by cesarean. The birth with cesarean section was performed according to obstetric causes in fourteen cases (93%). None of the patients experienced postpartum complications. The mean platelet count of newborn babies was 201,521±95.46/mm 3 (range, 35,900-446,000) and none of them experienced hemorrhagic complication. Conclusion: Although women with immune thrombocytopenic purpura carry the risk in pregnancy, birth and after birth, maternal and fetal outcomes are better than expected by appropriate treatment. Decision regarding the form of birth can be made according to obstetric causes in these patients. Kronik immun trombositopenik purpural› gebelerde maternal ve fetal sonuclar›n›n retrospektif analizi Amac: Bu cal›flmada kronik immun trobositopenik purpura tan›l›