[Idiopathic thrombocytopenic purpura in pregnancy. Interdisciplinary care, demonstrated on a case report with a review of the literature].

The case is reported of a 30-year-old primigravida presenting with idiopathic thrombocytopenic purpura (ITP) at 31 weeks gestation. Because the thrombocytopenia became progressively resistant to steroids, pregnancy was terminated at 36 weeks gestation by primary caesarean section after platelet transfusion. Subsequent therapy with high-dose intravenous gammaglobulin transiently reversed the thrombocytopenia. However, 3 weeks after delivery splenectomy was performed because of relapse of ITP. The baby showed only very mild, transient thrombocytopenia without clinical symptoms. Based on a literature survey covering 159 deliveries of women with ITP described in 18 publications in the period 1973-1982, the following points are discussed: 1. risk of ITP in pregnancy for mother and child (maternal mortality 0.6% per delivery, perinatal mortality 2.4%, risk of neonatal intracranial hemorrhage 2.4%), 2. therapy of ITP in pregnancy and its effects on the fetus; 3. mode of delivery; 4. perinatal management of the mother; 5. management of the newborn.