the admission charts of the patients in an almost 10- year period and 132 pregnancies belonged to 125 mothers were included. Fifty-eight cases were diag- nosed before pregnancy and 75 were diagnosed dur- ing pregnancy. The maternal ages ranged between 16-40 years (mean 26.49±4.8 years) and maternal platelet counts were between 3,000-200,000/µL (mean 62,850±39,081/µL). However, 115 women (86.6%) were classified to have moderate to severe thrombo- cytopenia with platelet counts of below 100,000/µL and 56 of them (42.1%) had PC< 50,000/µL. On the contrast, among the neonates with the mean platelet count of 146,040±60,995/µL, one hundred and thir- teen (84.9%) had platelet counts of more than 100,000/µL. Thirteen neonates (9.8%) had platelet counts between 50,000-100,000/µL and only 3 (2.3%) had platelet counts below 50,000/µL. None of these neonates showed severe bleeding complications and there was no case of intracranial hemorrhage. How- ever, higher rates had been reported for severe neona- tal thrombocytopenia in previous studies.13 Neonatal PC may drop during few days after birth and the dif- ference may be caused by measuring PCs at different durations from delivery. This low rate of fetal severe thrombocytopenia emphasizes that performing inva- sive procedures before delivery for the measurement of fetal PCs may not be justified. Analysis of our data showed no correlation between maternal and neonatal platelet counts. Although the mean gestational age at delivery was 266.4±15.6 days in this study, 31 neonates (23.3%) had PTBs and 32 neonates had NICU admissions mostly due to prematurity and its complications. The incidence of PTB in most developed countries is about 5-10%.14 However, higher PTB rates have been reported for some populations,15 but it is estimated to be about 5% in the general population in our centers.16 The calculated PTB rate of 23.3% for the pregnancies complicated by ITP in this study was four times higher. Among this study group, there were 18 women (13.6%) who developed preeclampsia. Regarding the fact that hypertensive disorders complicate 5-10% of pregnancies,8 the calculated rate of 13.6% for the parturients with ITP is more than general population. In this study, there were 15 women (11.4%) diagnosed to have either impaired glucose tolerance test or overt diabetes. Compared to the rate of diabetes estimated to be about 4.2%,17 this study showed a higher tendency for impaired glucose Pregnancies with thrombocytopenia metabolism in this population. Higher rates of preeclampsia and diabetes in this group may be consequences of associated vascular problems or as a complication of corticosteroid therapy. Antiplatelet antibodies may cross the placenta and cause thrombocytopenia and bleeding complications in the neonate. Obstetricians are always worried about birth trauma and especially ICH in a thrombo- cytopenic neonate. From a historical point of view, it was suggested to perform umbilical blood sampling near term18 and cesarean delivery was considered to be indicated for the thrombocytopenic fetuses or for the mothers who have positive circulating platelet anti- body test.19 However evidence showed that invasive tests have little effect in preventing neonatal complica- tions20,21 and it is now a general agreement that vaginal delivery is preferred for the parturients with ITP unless an obstetric indication occurs.22,23 In this study, 55 women (41.4%) had normal vaginal deliveries and 74 cases (55.6%) delivered abdominally. The most fre- quent indication for cesareans was fetal distress that occurred for 32 cases (43.2%). The mean neonatal birth weight was 29189±588.36 grams. Five minutes apgar scores below 7 was seen only in 8 neonates (6%) including 2 dead fetuses. These two fetuses that were dead on admission in addition to the three neonates that had platelet counts less than 50,000/µL were all born from the mothers with chronic ITP. So, we sub-classified all of the women to two groups (diagnosed before pregnancy and diagnosed dur- ing pregnancy) and compared the outcomes between them. We noticed that maternal age, maternal platelet counts, gestational age at delivery, 5 minutes apgar scores<7, rate of abdominal deliveries, mean neonatal birth weights and the mean neonatal platelet counts were not statistically different between the two groups. How- ever, NICU admissions were significantly higher in the group that were diagnosed before pregnancy, 20 (34.48%) compared to 12 (16%) (p=0.01). Suggesting that fetus in a chronic case may probably be more com- promised and fetal well being evaluations are more strongly recommended for this group during pregnancy. Eleven women (8.3%) did not receive any medica- tion. However, the most frequently used medication were corticosteroids (n=121, 91.7%). Fourteen wom- en (10.5%) who did not respond to corticosteroids to rise their platelet counts received IVIG during preg- nancy. Sixty three (47.4%) had platelet transfusions at the time of normal delivery or cesarean. Some pa- tients in this study were over-treated compared to the clinical guidelines,5,6,24 which reflects the fear of the WWW.ircmj.com Vol 14 July 2012 433