RISK OF THROMBOCYTOPENIA IN THE INFANTS OF MOTHERS WITH IDIOPATHIC THROMBOCYTOPENIA

Twenty-nine of 27,662 pregnant women had autoimmune thrombocytopenia a t the time of delivery at King Khalid University Hospital over 6 years starting June 1986. Twenty-six had idiopathic thrombocytopenic purpur a (ITP), gave birth to 33 infants, of which 22 were by spontaneous vag inal delivery, eight by lower segment cesarean section, and two by for ceps. Fourteen (44%) of the 32 living infants had platelets less than 150 x 10(9)/L and four (12.5%) had severe thrombocytopenia (platelets less than 50 x 10(9)/ L). The mothers' platelets of less than 50 x 10( 9)/L at delivery were found to be predictive of thrombocytopenia in th eir infants (P < 0.027), compared with mothers' platelet of more than 50 x 10(9)/L. Maternal treatment with prednisone did not seem to have significant effect on infants' platelets (P < 0.89). All infants with severe thrombocytopenia (less than 50 x 10(9)/L) at birth had ultrasou nd done and were found to be normal. We conclude that: (1) steroid giv en to pregnant women with ITP does not increase infants' platelet coun ts, (2) severe thrombocytopenia in the mothers (platelet counts less t han 50 x 10(9)/L) is highly predictive of thrombocytopenia in their in fants; (3) cesarean section should be limited to the mother with sever e thrombocytopenia if fetal scalp platelets are less than 50 x 10(9)/L .