ABSTRACT
Immune thrombocytopenic purpura (ITP) is a condition in which platelets are destroyed prematurely by antiplatelet antibodies. There is no diagnostic test, the condition is diagnosed by exclusion of other causes of thrombocytopenia. The platelet count is persistently low, but the FBC, blood film, PT and APTT are normal. Tests for antiplatelet antibodies are non-specific and do not distinguish ITP from gestational thrombocytopenia. Bone marrow biopsy may be needed for diagnosis. The mode of delivery in cases of ITP remains a subject of debate. In each case, it should be decided by the consultant obstetrician and consultant haematologist, with the consent of the woman. Antiplatelet antibodies may cross the placenta, causing fetal thrombocytopenia. This may manifest as purpura, haematuria or intracranial haemorrhage. Neither prednisolone therapy nor IV immunoglobulin given to the mother can prevent fetal thrombocytopenia.
