women s health issues
Autoimmune Disorders During Pregnancy
Immune Thrombocytopenia (ITP)
In Overview of Thrombocytopenia , antibodies decrease the number of platelets (also called thrombocytes) in the bloodstream. Platelets are cell-like particles that help in the clotting process. Too few platelets (thrombocytopenia) can cause excessive bleeding in pregnant women and their babies. If not treated during pregnancy, immune thrombocytopenia tends to become more severe. The antibodies that cause the disorder may cross the placenta to the fetus. However, they rarely affect the platelet count in the fetus. The fetus can usually be delivered vaginally. Corticosteroids Sometimes immune globulin, given intravenously Corticosteroids, usuallyprednisonegiven by mouth, can increase the number (count) of platelets and thus improve blood clotting in pregnant women with immune thrombocytopenia. However, this improvement lasts in only about half of women. Also,prednisoneincreases the risk that the fetus will not grow as much as expected or will be born prematurely. Women who have a dangerously low platelet count may be given high doses of immune globulin intravenously shortly before delivery. Immune globulin (antibodies obtained from the blood of people with a normal immune system) temporarily increases the platelet count and improves blood clotting. As a result, labor can proceed safely, and women can have a vaginal delivery without uncontrolled bleeding. Pregnant women are given platelet transfusions only when the platelet count is so low that severe bleeding may occur or sometimes when cesarean delivery is needed. Rarely, when the platelet count remains dangerously low despite treatment, doctors remove the spleen, which normally traps and destroys old blood cells and platelets. The best time for this surgery is during the 2nd trimester. 