Autoimmune thrombocytopenic purpura: maternal and fetal disease

Abstract We have followed up 63 pregnancies in women with autoimmune thrombocytopenic purpura (ATP). Of these, 15 were previously splenectomized. The characteristics of the sample can be summed up as follows: average age 27 years (17–41); platelets at the beginning of pregnancy, x 129.5 × 10 9 /1 (range 16–488); platelets at delivery, x 133 × 10 9 /1 (range 8–477); PA-IgG at delivery, x 320 ng IgG/10 7 platlets (range 10–1000); SPB-IgG at delivery, x 262 ng IgG/10 7 platlets (range 10–1000). There were 30 spontaneous deliveries and 33 cesarean sections. Forty-two newborns had a platelet count within the normal range while nine had a platelet count ≤ 150 × 109/1, while six had s 100 × 10 9 /1 and a further six ≤ 50 × 10 9 /1. The aim of this study is the evaluation of maternal risk and of possible feto-neonatal thrombocytopenia at birth. In this regard, the following parameters were considered: previous maternal splenectomy; the platelet count at the beginning of pregnancy; the platelet count and the titres of PA-IgG and SPB-IgG at delivery. Preliminary statistical evaluation of these parameters enabled us to identify a risk score. From this it was possible to obtain an optimum management of the final stage of pregnancy regarding the therapeutic approach and the timing of delivery.