CESAREAN SECTION OF PATIENTS WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA

• Published in: Japanese Journal of National Medical Services Vol. 56; no. 7; pp. 427 - 431
• Main Authors: KITAOKA, Yuki, NAKAMURA, Yukio, YOSHIZATO, Toshiyuki, HAYASAKA, Atsushi, NAITO, Hiroyuki, HASHIMOTO, Tadashi, GOTO, Shunji, OKAGAKI, Atsuhiko
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 20.07.2002
• Subjects: cesarean section; idiopathic thrombocytopenic purpura; neonatal thrombocytopenia; percutaneous umbilical cord blood sampling
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.56.427

The management and mode of delivery of pregnant women with idiopathic thrombocytopenic purpura has been a subject of substantial controversy. The purpose of this report is to relate our 5-year experience with maternal idiopathic thrombocytopenic purpura and to review the literatures with regard to fetal risks associated with severe neonatal thrombocytopenia and with mode of delivery. Fifty-four pregnancies with idiopathic thrombocytopenic purpura in 8 national hospitals were evaluated. Nineteen cases of those were delivered by cesarean section for various obstetric indications and 35 cases vaginally. There were 4 neonates with severe thrombocytopenia and no severe complication. These findings, combined with others in the literature, confirm that severe neonatal thrombocytopenia is an infrequent complication of maternal idiopathic thrombocytopenic purpura. Intracranial hemorrhage is a further rare event and is not related to mode of delivery. Cesarean section therefore should be reserved for obstetric indications only.