Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Severe Immune Thrombocytopenic Purpura in a Patient at 33 Weeks of Gestation: A Case Report

Authors
Rawad Halimeh 1
Joseph Klim 2
Lea Aoude 2
Marianne Bersaoui 3
Bernard Najib 4
Saab Wiam 5
Fadi Fakhoury 6
Rana Skaf 3
1 The Centre for Reproductive and Genetic Health (CRGH), London, UK
2 Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
3 Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon
4 Centre Antoine Lacassagne, Nice, France
5 Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
6 Department of Anesthesia, Montreuil Intercommunal Hospital Center, Montreuil, France
10.18502/jri.v26i1.18782
Abstract
Background: Immune thrombocytopenia (ITP) is an autoimmune condition that affects individuals of all ages, leading to a heightened risk of bleeding. ITP accounts for 5% of all pregnancy-related thrombocytopenia cases with an incidence of 1 in every 1,000 pregnant women. Several conditions can cause thrombocytopenia during pregnancy, making the diagnosis challenging. Current treatment of patients with ITP focuses on maintaining a safe platelet count rather than correcting it to normal levels. Case Presentation: This article presents a case of a 26-year-old patient at 33 weeks of gestation with severe symptoms of thrombocytopenia, evidenced by a platelet count of 1000/mm 3 . The patient experienced self-resolving episodes of gingival bleeding, vaginal bleeding, and petechiae on her abdomen, as well as on both upper and lower extremities, over a duration of three days. She was successfully managed with prednisolone and intravenous immunoglobulin (IVIG), resulting in favorable maternal and neonatal outcomes. Conclusion: While there are currently no universally accepted guidelines for the treatment of ITP, expert consensus recommendations are available. Therefore, treatment should be individualized and closely monitored. A multidisciplinary team approach is essential for the effective management of ITP during pregnancy.
Keywords
Bleeding
Immune thrombocytopenia
immunoglobulins
Platelet count
Prednisolone
Pregnancy
Purpura
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Journal of Reproduction & Infertility
Volume 26, Issue 1
Winter 2025
Pages 58-63