2 Cases of Refractory Idiopathic Thrombocytopenic Purpura in Pregnancy

Case 1: A woman in her 30s was diagnosed with immune thrombocytopenic purpura (ITP) in February 20XX and her pregnancy was detected in March 20XX. Her platelet count decreased and prednisolone was started at gestational week 22. However, due to treatment resistance, intravenous immunoglobulin (IVIG) was used in combination. She required IVIG every two weeks to maintain an adequate platelet count. At 34 weeks and 1 day of gestation, preterm premature rupture of membranes occurred and the woman gave birth vaginally. A woman in her 20 s was diagnosed with ITP at the age of 10 years, she underwent splenectomy at the age of 20 years. When her pregnancy was detected in April 20XX, platelet counts were 1-2 × 10 10 ╱ L with no medication. As her pregnancy progressed, her platelet count decreased despite corticosteroid treatment. Although a response to IVIG was observed, maintenance of platelet count was insufficient. At 30 weeks and 5 days of gestation, premature separation of the normally positioned placenta occurred, and the woman gave birth with emergency cesarean section. Discussion: It is important to keep platelet counts to reduce maternal and neonatal complications. Therefore further investigation is necessary to establish alternative therapies in pregnant women with ITP who are resistant to recommended treatments.