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    Is it possible to predict morbidities in neonates born to mothers with immune thrombocytopenic purpura?: A retrospective cross-sectional study
    (Lippincott Williams & Wilkins, 2024) Aslan, Mustafa Torehan; Ince, Zeynep; Bilgin, Leyla; Isguder, Cigdem Kunt; Coban, Asuman
    Immune thrombocytopenic purpura (ITP) comprises similar to 1% to 4% of thrombocytopenia cases during pregnancy. Factors predicting neonatal thrombocytopenia and associated morbidities due to maternal ITP are unclear. The present study aimed to assess the neonatal outcomes of pregnant women with ITP. Fifty-five pregnant women with ITP and their babies, born between January/2013 and April/2021, were retrospectively reviewed. Maternal and neonatal thrombocytopenia cases other than ITP were excluded from the study. Physical examination, blood count, and cranial/abdominal ultrasonography findings of the newborns were recorded. Neonatal thrombocytopenia was defined as a platelet count < 150 x 10(9)/L. Relationship between neonatal thrombocytopenia and maternal factors was investigated. Thrombocytopenia was detected in 17/55 babies (30.9%), and 8/17 (47.1%) had symptoms of bleeding, all but one being mild bleeding. There was a significant correlation between neonatal platelet counts of < 100 x 10(9)/L and maternal splenectomy history. Incidence of moderate and severe thrombocytopenia was higher (statistically insignificant) in neonates of mothers with ITP. No significant correlation was determined between maternal and neonatal platelet counts. There was a weak insignificant correlation between platelet counts of neonates of mothers with or without thrombocytopenia. A significant correlation was found between the presence of splenectomy before delivery in the mother and a platelet count of < 100 x 10(9)/L in the neonate. Moderate and severe thrombocytopenia was higher in neonates of mothers diagnosed with ITP before pregnancy and needed treatment during pregnancy and/or delivery, but the difference was insignificant. Close follow-up of babies born to mothers with ITP after birth is crucial since there is no significant prediction criterion for developing neonatal thrombocytopenia and associated morbidities.
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    THE DETERMINANTS IN THE MANAGEMENT OF PREGNANCIES COMPLICATED WITH IMMUNE THROMBOCYTOPENIA
    (Istanbul Univ, Fac Medicine, Publ Off, 2023) Isguder, Cigdem Kunt; Sivrikoz, Tugba Sarac; Akin, Mehtap; Aslan, Torehan; Uygur, Lutfiye Selcuk; Ince, Sule Birol; Kalelioglu, Ibrahim
    Objective: This study aims to determine the hematologic and obstetric factors that would affect the management of immune thrombocytopenia (ITP) during pregnancy.Material and Method: This is a retrospective review of 54 pregnancies that were complicated by ITP at a single tertiary center. All of the patients were followed-up and delivered at the same center. Subgroup analysis for obstetric outcomes was made accord-ing to the platelet counts at the time of delivery (<50x10(3)/mm(3) or 250x10(3)/mm(3)), the time of diagnosis (before or during pregnancy) and neonatal platelet counts (<= 100x10(3)/mm(3) or >100x103/mm3).Result: Transfusion of blood products, steroid administration per se, or in combination with intravenous immunoglobulins (IVIG), were significantly more often administered in those with platelet counts <50x10(3)/mm(3) at the time of delivery (p=0.020, p=0.020, and p=0.004, respectively). The patients who were first diagnosed with ITP during pregnancy had higher rates of transfusion of blood products (p=0.041), higher rates of vaginal deliveries (p=0.048), and lower rates of preterm delivery (p=0.044) when compared to the patients who had ITP diagnosed before the on- set of pregnancy. Gestational age at birth (p=0.020), birth weight (p=0.002) and neonatal platelet count (p=0.002) were significantly higher in those who were diagnosed during the pregnancy. History of maternal splenectomy, intensive care unit admission, IVIG administration, and blood transfusion were significantly more frequent in neonates with platelet counts <= 100x10(3)/mm(3) (p=0.028, p=0.001, p=0.001, and p=0.025, respectively).Conclusion: The women diagnosed with ITP before the pregnancy and those who were diagnosed during the pregnancy had comparable rates of postpartum bleeding. However, there was a tendency towards overtreatment of the women who developed ITP during pregnancy.