ITP in Pregnancy
There are generally ways ITP can occur in pregnancy. The first include women with a pre-existing diagnosis of ITP who become pregnant and then there are women who are diagnosed with ITP during their pregnancy.
It’s known that women with pre-existing ITP may experience a drop in platelet count during pregnancy, or relapse if in remission.
Women with ITP who then become pregnant
Many women with ITP have concerns around starting a family due to the autoimmune disease. Having ITP should not prevent women from becoming pregnant or delivering a healthy child. The vast majority of women with pre-existing ITP will have a successful pregnancy, but closer monitoring and sometimes treatment is needed to ensure the best outcome.
It’s recommended that prior to pregnancy, you discuss your management with your medical professional.
Diagnosis of ITP During Pregnancy
Sometimes a low platelet count is discovered during pregnancy. This can be due to gestational thrombocytopenia. It is normal for the platelet count to fall in pregnancy, and those women with gestational thrombocytopenia are those at the extreme lower end of the spectrum. Treatment is very rarely needed and the platelet count will return to normal between pregnancies.
ITP can also be diagnosed during pregnancy. This generally results in more severe thrombocytopenia, and treatment may be needed, particular around the time leading up to birth. The platelet count may not fully recover after pregnancy.
We recommend that there be coordination between your GP, obstetrician and a haematologist (or obstetric physician) with experience in managing ITP in pregnancy.
ITP itself does not mean that a Caesarean delivery is required, and normal delivery is usually possible unless there are other medical concerns with the mother or baby.
Treatment of ITP during Pregnancy
Treatments such as prednisolone and IVIg can be given to women with ITP during pregnancy in preparation for delivery. TPORA treatments are not recommended during pregnancy, although recent research from China has suggested that certain TPORAs can be used safely, however we encourage women to speak with their medical professional during their pregnancy.