Contributions
Abstract: PB2125
Type: Publication Only
Background
Aims
The aim is to describe the prevailing ITP progression profile in pregnant women and to evaluate the risk of neonatal thrombocytopenia in two situations, when ITP was known before pregnancy and when ITP was discovered for first time during pregnancy.
Methods
It is a retrospective study carried out in the hematology department of CAC Blida, Algeria, between 1993 and 2016. All patients (pts) who had a pre-pregnancy ITP or thrombocytopenia during pregnancy attached to an ITP were included.
Results
The development of 89 pregnancies (PG), including two twins, occurred in 59 women was analyzed. There were one PG in 40 pts, 2 PG: 13 pts, 3 PG : 5 cases, 4 PG : 1 case and 5 PG : 1 case. Of the 59 pts: in 42 cases it was a history of ITP before pregnancy (group 1: G1) with a history of splenectomy in 9 patients, and in 17 cases it was ITP discovered on the occasion of Pregnancy (group 2: G2). The average age at diagnosis = 26.7 years (7-44) and that at delivery = 30.4 years (19-44). The mean platelet count at diagnosis: G1: 34000 / µL, G2: 47000 / µL. In the first group (G1): At the beginning of pregnancy the ITP was chronic in 30 cases, newly diagnosed in 1 case, persistent in 2 cases and transient cured in 7 cases; treatments previously received were: corticosteroid therapy (n=34), splenectomy (n=9), Danazol (n=1), cyclosporine in 1 case and cyclophosphamide in 1 case, abstention in 7 pts, 2 of whom required corticosteroids during pregnancy. The status of the ITP at the beginning of each pregnancy was: out of treatment (n=8), corticosteroid dependence (n=5), non-response (n=7), PR (n=11), CR (n=24).In the second group (G2): the discovery of thrombocytopenia was in the first trimester (T) in 4 cases, in the second T in 6 cases and in the third T in 7 cases; 17 pts had platelet counts < 80000 / µL and were included due to the persistence or even worsening and / or necessity to resort to treatment of thrombocytopenia after delivery. In both groups: in 26 pts (G1:16; G2: 10 )variable dose and duration treatment were required during pregnancy; at delivery, 19 patients needed a treatment, out of them, a bolus of corticosteroids (n=11) + transfusion of platelets (n=4), immunoglobulins in 4 cases and transfusion of platelets alone in 4 cases. At birth, thrombocytopenia was observed in 40 pregnancies (50.6%): platelets < 30000 / µL (n=7), between 31000 and 50000 /µL (n=13), between 51000 and 100000/µ (n=20), between 100000 and 150000/µl in 2 cases. All pregnancies were completed: 14 by caesarean section, one for thrombocytopenia, with an average platelet count = 95000 /µL and 75 by natural delivery with a mean platelet count = 100000 / µL with 4 deaths born, one anencephaly and 88 newborns No hemorrhagic syndrome was observed in pregnancy; two postpartum hemorrhages were seen in G2 group. Eleven newborns (5 in G1 and 6 in G2) were thrombocytopenic with platelet count < 20000/µL in 4 cases; between 20000 and 50000/µL in 7 cases; neonatal thrombocytopenia occurred during the first 7 days. Only 4 newborns were treated, one by corticosteroid and 3 by immunoglobulins, with a good progression and only one of the untreated is always followed for thrombocytopenia.
Conclusion
Session topic: 32. Platelets disorders
Keyword(s): Pregnancy, Immune thrombocytopenia (ITP)
Abstract: PB2125
Type: Publication Only
Background
Aims
The aim is to describe the prevailing ITP progression profile in pregnant women and to evaluate the risk of neonatal thrombocytopenia in two situations, when ITP was known before pregnancy and when ITP was discovered for first time during pregnancy.
Methods
It is a retrospective study carried out in the hematology department of CAC Blida, Algeria, between 1993 and 2016. All patients (pts) who had a pre-pregnancy ITP or thrombocytopenia during pregnancy attached to an ITP were included.
Results
The development of 89 pregnancies (PG), including two twins, occurred in 59 women was analyzed. There were one PG in 40 pts, 2 PG: 13 pts, 3 PG : 5 cases, 4 PG : 1 case and 5 PG : 1 case. Of the 59 pts: in 42 cases it was a history of ITP before pregnancy (group 1: G1) with a history of splenectomy in 9 patients, and in 17 cases it was ITP discovered on the occasion of Pregnancy (group 2: G2). The average age at diagnosis = 26.7 years (7-44) and that at delivery = 30.4 years (19-44). The mean platelet count at diagnosis: G1: 34000 / µL, G2: 47000 / µL. In the first group (G1): At the beginning of pregnancy the ITP was chronic in 30 cases, newly diagnosed in 1 case, persistent in 2 cases and transient cured in 7 cases; treatments previously received were: corticosteroid therapy (n=34), splenectomy (n=9), Danazol (n=1), cyclosporine in 1 case and cyclophosphamide in 1 case, abstention in 7 pts, 2 of whom required corticosteroids during pregnancy. The status of the ITP at the beginning of each pregnancy was: out of treatment (n=8), corticosteroid dependence (n=5), non-response (n=7), PR (n=11), CR (n=24).In the second group (G2): the discovery of thrombocytopenia was in the first trimester (T) in 4 cases, in the second T in 6 cases and in the third T in 7 cases; 17 pts had platelet counts < 80000 / µL and were included due to the persistence or even worsening and / or necessity to resort to treatment of thrombocytopenia after delivery. In both groups: in 26 pts (G1:16; G2: 10 )variable dose and duration treatment were required during pregnancy; at delivery, 19 patients needed a treatment, out of them, a bolus of corticosteroids (n=11) + transfusion of platelets (n=4), immunoglobulins in 4 cases and transfusion of platelets alone in 4 cases. At birth, thrombocytopenia was observed in 40 pregnancies (50.6%): platelets < 30000 / µL (n=7), between 31000 and 50000 /µL (n=13), between 51000 and 100000/µ (n=20), between 100000 and 150000/µl in 2 cases. All pregnancies were completed: 14 by caesarean section, one for thrombocytopenia, with an average platelet count = 95000 /µL and 75 by natural delivery with a mean platelet count = 100000 / µL with 4 deaths born, one anencephaly and 88 newborns No hemorrhagic syndrome was observed in pregnancy; two postpartum hemorrhages were seen in G2 group. Eleven newborns (5 in G1 and 6 in G2) were thrombocytopenic with platelet count < 20000/µL in 4 cases; between 20000 and 50000/µL in 7 cases; neonatal thrombocytopenia occurred during the first 7 days. Only 4 newborns were treated, one by corticosteroid and 3 by immunoglobulins, with a good progression and only one of the untreated is always followed for thrombocytopenia.
Conclusion
Session topic: 32. Platelets disorders
Keyword(s): Pregnancy, Immune thrombocytopenia (ITP)