pregnancy outcomes in women with idiopathic thrombocytopenic purpura

background: idiopathic thrombocytopenic purpura (itp) is a disease that commonly affects women of reproductive age and is associated with maternal and fetal complications. objective: the aim of the present study was to report the perinatal outcome in pregnant women with itp. materials and methods: twenty one pregnant women with itp admitted in a teaching hospital in tehran, from october 2008 to february 2010, were enrolled in this prospective historical cohort study; course and perinatal outcome of pregnancies were studied. results: seven (33.3%) cases had been diagnosed before pregnancy, while the other fourteen (66.7%) were diagnosed during pregnancy. during hospitalization, thirteen (62%) patients required treatment, eight (61.5%) of them with steroids, two (15.3%) received intravenous immunoglobulin (ivig), and three (23%) were treated with steroids and ivig. three babies were delivered vaginally (14.3%), seventeen (81%) through cesarean section and one patient aborted her fetus. nine mothers (42.9%) had platelet counts <50000/ml at the time of delivery; but postpartum hemorrhage occurred in 4 (19%) women and one women received platelet transfusion during cesarean section. six (28.6%) women developed gestational diabetes. pregnancy was complicated by preeclampsia in one woman and by abruptio placenta in another. one pregnancy terminated in intrauterine fetal death. seventeen infants (89.5%) had normal platelet counts, and two (10.5%) had moderate thrombocytopenia. no infant showed signs of hemorrhage, but 2 neonates (10.5%) were diagnosed with intrauterine growth restriction. conclusion: rate of gestational diabetes in pregnant women with itp is higher than the general population. rate of gestinational diabetes is 3-5% and postpartum hemorrhage is 5-7% in general. postpartum hemorrhage is common in these women. severe thrombocytopenia and bleeding in the newborns are uncommon.