Obstetric and Neonatal Outcomes of Immune Thrombocytopenic Purpura During Pregnancy: The Role of Delta Hemoglobin Index

A study conducted by Ipek et al investigated the impact of idiopathic thrombocytopenic purpura (ITP) on pregnancies and the role of the delta hemoglobin indices in assessing the efficacy of treatment.

This case-control study involved 23 pregnancies with immune thrombocytopenic purpura (ITP) and 115 low-risk pregnancies. Researchers recorded various obstetric outcomes, including fetal growth retardation (FGR) and preterm delivery, as well as neonatal outcomes such as birth weights, APGAR scores, NICU admissions, and instances of thrombocytopenia. The ITP group was further divided based on platelet ratios at the time of admission for delivery, allowing for an evaluation of how these platelet ratios influenced blood loss during delivery, assessed through delta hemoglobin indices.

In a study involving eleven patients treated for ITP during pregnancy, findings indicated the following:

• The gestational age at birth and fetal APGAR scores were lower in the ITP group, while rates of preterm delivery and fetal growth restriction (FGR) were higher.
• Thrombocytopenia was observed in four newborns (17.4%), and there were two cases of postpartum hemorrhage.
• Notably, newborn platelet counts did not correlate with maternal platelet counts, and there was no significant difference in delta hemoglobin counts between the ITP and control groups.

Thus, the study concluded that ITP is linked to a higher risk of maternal and fetal complications. The study indicated that effective management using delta hemoglobin indices could help prevent hemorrhagic complications. Additionally, neonatal thrombocytopenia should be monitored in all ITP patients.

Source: Ipek G, et al. Obstetric and neonatal outcomes of immune thrombocytopenic purpura in pregnancy and the role of delta hemoglobin index: A case–control study from a tertiary center. The Journal of Obstetrics and Gynaecology Research. Oct 2024. https://doi.org/10.1111/jog.16133.