Management of Primary Immune Thrombocytopenia in Pregnancy

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by accelerated platelet destruction and reduced platelet production, affecting 1 to 3 cases per 10,000 persons in the U.S. This review focuses on the complexities of diagnosing and managing ITP during pregnancy, where maternal thrombocytopenia and placental transfer of antiplatelet antibodies can complicate outcomes. The article discusses pathophysiology, risk assessment, and treatment strategies, including first-line therapies like prednisone and IVIG, and second line options such as thrombopoietin-receptor agonists. It highlights the challenges of neonatal thrombocytopenia and provides clinical insights for managing refractory cases.

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by accelerated platelet destruction and reduced platelet production, affecting 1 to 3 cases per 10,000 persons in the U.S. This review focuses on the complexities of diagnosing and managing ITP during pregnancy, where maternal thrombocytopenia and placental transfer of antiplatelet antibodies can complicate outcomes. The article discusses pathophysiology, risk assessment, and treatment strategies, including first-line therapies like prednisone and IVIG, and second line options such as thrombopoietin-receptor agonists. It highlights the challenges of neonatal thrombocytopenia and provides clinical insights for managing refractory cases.