2017 Volume 69 Issue 3 Pages 288-292
Idiopathic thrombocytopenic purpura (ITP) is prevalent in young women, occurring in 0.3 to 0.4% of pregnant women. We a case of intractable ITP in pregnancy that was not cured by corticosteroid therapy or intravenous immunoglobulin, but was cured with difficulty, using thrombopoietin receptor agonist (TPO-RA) . The patient was a 30-year-old woman (gravida 0), who was admitted with thrombocytopenia (platelet count of 75000 /μl) after previously visiting a doctor for infertility treatment . It was suspected that autoimmune disease was the cause. She visited our hospital six months later, in her eighth week of pregnancy, and was admitted with thrombocytopenia (platelet count of 53000 /μl). The thrombocytopenia progressed gradually and her illness was diagnosed by bone marrow puncture as ITP. The thrombocytopenia was not cured by corticosteroid therapy or intravenous immunoglobulin, therefore we administered a thrombopoietin receptor agonist, as well as platelet transfusions over several days. The patient had a cesarean section at 36 weeks five days of gestation when the platelet count increased to 63000 /μl). The platelet count promptly rose after the operation. In this case, it was difficult to cure the ITP and a thrombopoietin receptor agonist was used. It is important to make a thorough treatment plan, cognizant of the delivery date, and considering the effect of each treatment on intractable ITP. [Adv Obstet Gynecol, 69 (3) : 288-292, 2017 (H29.8)]
