Iranian Red Crescent Medical Journal Perinatal Outcome of Pregnancies Complicated by Immune Thrombocytopenia B Namavar Jahromi1*, Z Shiravani2, L Salarian2 1Perinatology Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, 2Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran ORIGINAL ARTICLE Abstract Background: Immune thrombocytopenia (ITP) is an autoimmune disorder that leads to premature destruction of antibody-coated platelets. This study evaluated perinatal outcome and medications used for pregnancies compli- cated by ITP. Methods: Medical records of 132 pregnancies belonged to 125 parturients with ITP who delivered between March 2001 and January 2011 were reviewed. Cases were included if diagnosed before pregnancy or if their platelet counts (PCs) were less than 80,000/µL during pregnancy without any other cause. Maternal and fetal outcomes were compared. Results: Fifty six mothers (42.1%) had PC<50,000, 18 women (13.5%) developed preeclampsia and 15 (11.3%) were diabetics. Corticosteroid was used for120 cases (90.9%) and intravenous immunoglobulin for 14 women (10.5%). PCs of 114 neonates were available in the charts and 84 (83.2%) had PC>150,000/µL. Three neonates (2.3%) had PC<50 000, 31 neonates (23.3%) had preterm births and 32 (24.1%) needed NICU admissions. Fifty seven cases of ITP (43.2%) were diagnosed before pregnancy and 75 (56.8%) were diagnosed during pregnancy. There were 2 intrauter- ine fetal deaths and higher NICU admissions, 20 (34.48%) versus 12 (16%) in the first group (p=0.01). Conclusion: Perinatal outcome of pregnancies with ITP is generally good. However neonates born from parturi- ents with chronic ITP needed more NICU admissions. Keywords: Immune thrombocytopenia; Perinatal; Outcome; Iran Introduction Immune thrombocytopenia (ITP) is an autoimmune disorder that leads to premature destruction of anti- body-coated platelets. For the diagnosis of ITP there is no approved confirmatory laboratory test at pre- sent. Diagnosis is made by demonstrating an isolated thrombocytopenia without an obvious cause. An- tiplatelet antibodies may cross the placenta and cause bleeding complications in the neonate.1,2 Preg- nancy with ITP is sometimes difficult to manage due to bleeding potentials for the mother and her fetus *Correspondence: Bahia Namavar Jahromi, MD, Perinatology Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Tel/Fax: +98-711-2332365, e-mail: namavarb@sums.ac.ir Received: December 30, 2011 Accepted: February 25, 2012 during peripartum periods. Thrombocytopenia oc- curs in 7-10% of unselected pregnancies. However, ITP accounts for only 3% of these cases compared to gestational thrombocytopenia and hypertensive dis- orders of pregnancy that account for 74% and 21% of the cases, respectively.3,4 This project was de- signed to retrospectively study the outcome of preg- nant women with ITP and their neonates during an almost 10-year period. Materials and Methods This study was performed retrospectively from March 2001 to January 2011 in Hafez and Hazrate Zeinab hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Southern Iran. Thrombocytopenia Iran Red Crescent Med J 2012; 14(7):430-435 ©Iranian Red Crescent Medical Journal