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Vaginal delivery with immune thrombocytopenic purpura-induced severe thrombocytopenia

Idiopathic thrombocytopenic purpura (ITP) is the most common immune-related thrombocytopenia during pregnancy. Here, we present a case of ITP with acute flare-up during pregnancy. Worsening thrombocytopenia dropped the platelet count to 11,000/dL. Steroid treatment, intravenous immunoglobulin (IVIG) infusion, and anti-CD20 antibody therapy were all unsuccessful. Fortunately, no further critical maternal or fetal complications developed. Transient neonatal thrombocytosis was noted after delivery but was corrected with IVIG.