IMMUNE THROMBOCYTOPENIC PURPURA AND PERCUTANEOUS UMBILICAL BLOOD-SAMPLING - AN OPEN QUESTION

We performed a retrospective study of 26 pregnancies with chronic immu ne thrombocytopenic purpura (ITP) or incidental ITP. Thirteen pregnanc ies were followed without the use of percutaneous umbilical blood samp ling (PUBS) and 13 were followed sampling PUBS at 36-40 weeks of gesta tion. The overall prevalence of neonatal thrombocytopenia was 27%: 50% in chronic ITP, 12.5% in incidental ITP. Symptomatic thrombocytopenia occurred only in infants born to mothers with chronic ITP. Without th e use of PUBS, 2 symptomatic thrombocytopenic fetuses were vaginally d elivered and there was a high rate of cesarean sections in normal fetu ses. Owing to PUBS, a decrease of the cesarean section rate in normal fetuses was observed, but one fetal bradycardia (due to the technique) was encountered. PUBS resulted helpful to indicate the best route of delivery and reducing unnecessary cesarean sections in women with chro nic ITP, but in presence of incidental ITP the use of PUBS remains an open question.