Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study.
<h4>Objective</h4> <p>To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy.</p> <h4>Design</h4> <p>A prospective natio...
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| Format: | Journal article |
| Language: | English |
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Wiley
2017
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| _version_ | 1797056184413323264 |
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| author | Care, A Pavord, S Knight, M Alfirevic, Z |
| author_facet | Care, A Pavord, S Knight, M Alfirevic, Z |
| author_sort | Care, A |
| collection | OXFORD |
| description | <h4>Objective</h4> <p>To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy.</p> <h4>Design</h4> <p>A prospective national cohort study</p> <h4>Setting</h4> <p>United Kingdom</p> <h4>Population</h4> <p>Women with severe ITP; defined as platelets <50 x 109/l in pregnancy or antenatal treatment of isolated low platelets.</p> <h4>Methods</h4> <p>Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1st June 2013–31st January 2015 from all UK Consultant led obstetric units.</p> <h4>Main Outcome Measures</h4> <p>Incidence of Severe ITP in pregnancy</p> <h4>Results</h4> <p>The estimated incidence of severe ITP in pregnancy is 0.83 per 10,000 maternities (95% CI 0.68-1.00). 22 pregnant women (21%) did not receive any antenatal therapy, 85 (79%) had therapy. There was no difference between asymptomatic treated and untreated cohorts in severity of disease or outcome. Postpartum haemorrhage (51%) and severe postpartum haemorrhage (21%) was reported more frequently than the reported rate in the general pregnant population (5- 10%). No neonates required treatment for thrombocytopenia and there were no cases of neonatal intracranial bleeding.</p> <h4>Conclusions</h4> <p>Current UK management of severe ITP in pregnancy results in an exceptionally low morbidity and mortality for the neonate. Mothers with ITP remain at increased risk of severe post-partum haemorrhage and should be delivered at units that have the capacity to manage severe PPH effectively. Whilst balancing risks for pregnancy of prophylactic antenatal treatment in asymptomatic women against observed low disease morbidity, we may be over treating asymptomatic patients.</p> |
| first_indexed | 2024-03-06T19:19:48Z |
| format | Journal article |
| id | oxford-uuid:19ae3087-9b2f-421b-bc64-443d19e62a02 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:19:48Z |
| publishDate | 2017 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:19ae3087-9b2f-421b-bc64-443d19e62a022022-03-26T10:50:22ZSevere primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:19ae3087-9b2f-421b-bc64-443d19e62a02EnglishSymplectic Elements at OxfordWiley2017Care, APavord, SKnight, MAlfirevic, Z <h4>Objective</h4> <p>To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy.</p> <h4>Design</h4> <p>A prospective national cohort study</p> <h4>Setting</h4> <p>United Kingdom</p> <h4>Population</h4> <p>Women with severe ITP; defined as platelets <50 x 109/l in pregnancy or antenatal treatment of isolated low platelets.</p> <h4>Methods</h4> <p>Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1st June 2013–31st January 2015 from all UK Consultant led obstetric units.</p> <h4>Main Outcome Measures</h4> <p>Incidence of Severe ITP in pregnancy</p> <h4>Results</h4> <p>The estimated incidence of severe ITP in pregnancy is 0.83 per 10,000 maternities (95% CI 0.68-1.00). 22 pregnant women (21%) did not receive any antenatal therapy, 85 (79%) had therapy. There was no difference between asymptomatic treated and untreated cohorts in severity of disease or outcome. Postpartum haemorrhage (51%) and severe postpartum haemorrhage (21%) was reported more frequently than the reported rate in the general pregnant population (5- 10%). No neonates required treatment for thrombocytopenia and there were no cases of neonatal intracranial bleeding.</p> <h4>Conclusions</h4> <p>Current UK management of severe ITP in pregnancy results in an exceptionally low morbidity and mortality for the neonate. Mothers with ITP remain at increased risk of severe post-partum haemorrhage and should be delivered at units that have the capacity to manage severe PPH effectively. Whilst balancing risks for pregnancy of prophylactic antenatal treatment in asymptomatic women against observed low disease morbidity, we may be over treating asymptomatic patients.</p> |
| spellingShingle | Care, A Pavord, S Knight, M Alfirevic, Z Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title | Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title_full | Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title_fullStr | Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title_full_unstemmed | Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title_short | Severe primary autoimmune Thrombocytopenia (ITP) in pregnancy: A national cohort study. |
| title_sort | severe primary autoimmune thrombocytopenia itp in pregnancy a national cohort study |
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