LAUSR

Idiopathic thrombocytopenic purpura (ITP) is an auto-immune disorder and occurs in 1–2/10,000 pregnancies.[1] There are autoantibodies against the platelet membrane glycoproteins. Exacerbation of thrombocytopenia in pregnancy and peripartum haemorrhage has been reported.[2] New-borns of affected mothers can have neonatal thrombocytopenia and intraventricular bleed.[3] We present a case of a 24-year-old parturient of 33 weeks gestation with ITP posted for elective caesarean section. She gave a history of haematuria of 1 month and was found to have a platelet count of 10,000/μL. Antiphospholipid antibodies were negative, and she was diagnosed with ITP. She received intravenous immunoglobulin (IVIg) 0.4 g/kg for 5 days, tablet prednisolone 50mg once daily, single donor platelet (SDP) transfusions and was referred to our hospital. Haematology consultation was sought. IV dexamethasone 40 mg once daily for 4 days, a stat dose of subcutaneous romiplostim 5 μg/kg and SDP transfusions were given. Gastrointestinal surgery consultation was done to consider splenectomy. As there was no improvement in the platelet count, the decision was made to terminate the pregnancy. She was posted for an elective caesarean section under general anaesthesia.