LOW FETAL MORBIDITY IN PREGNANCY-ASSOCIATED WITH ACUTE AND CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

Forty-six mothers with immune thrombocytopenic purpura (ITP) gave birt h to 72 babies. Sixty-two babies were delivered vaginally and 10 babie s by cesarean section. There was no mortality among mothers or babies. Eighteen infants were born thrombocytopenic (PLT < 100.10(9)/l). Elev en infants had a platelet count of less than 50.10(9)/l. All the sever ely thrombocytopenic babies (except 1) were born to post splenectomy t hrombocytopenic mothers, regardless of steroid treatment during pregna ncy. Five babies had clinical manifestations of bleeding; 3 had mild p urpura, 1 severe gastrointestinal bleeding, and 1 intracranial bleedin g. The latter 2 babies were born prematurely to the same mother who wa s severely thrombocytopenic despite splenectomy in childhood. In view of very low morbidity in babies of ITP mothers, we suggest that they b e delivered vaginally. Cesarean delivery should be performed in select ed cases where the mother is severely thrombocytopenic despite splenec tomy or where prematurity or obstetrical complications are encountered . (C) 1994 Wiley-Liss, Inc.