Analysis of 339 pregnancies in 181 women with 13 different forms of inherited thrombocytopenia

Pregnancy in women with inherited thrombocytopenias is a major matter of concern as both the mothers and the newborns are potentially at risk of bleeding. However, medical management of this condition cannot be based on evidence because of the lack of consistent information in the literature. To advance knowledge on this matter, we performed a multicentric, retrospective study evaluating 339 pregnancies in 181 women with 13 different forms of inherited thrombocytopenia. Neither the degree of thrombocytopenia nor the severity of bleeding tendency worsened during pregnancy and the course of pregnancy did not differ from that of healthy subjects in terms of miscarriages, fetal bleeding and pre-term births. The degree of thrombocytopenia in the babies was similar to that in the mother. Only 7 of 156 affected newborns had delivery-related bleeding, but 2 of them died of cerebral hemorrhage. The frequency of delivery-related maternal bleeding ranged from 6.8% to 14.2% depending on the definition of abnormal blood loss, suggesting that the risk of abnormal blood loss was increased with respect to the general population. However, no mother died or had to undergo hysterectomy to arrest bleeding. The search for parameters predicting delivery-related bleeding in the mother suggested that hemorrhages requiring blood transfusion were more frequent in women with history of severe bleedings before pregnancy and with platelet count at delivery below 50 × 10(9)/L.Fil: Noris, Patrizia. Istituti di Ricovero e Cura a Carattere Scientifico. Policlinico San Matteo di Pavia; Italia. Università degli Studi di Pavia; ItaliaFil: Schlegel, Nicole. Université Paris Diderot - Paris 7; FranciaFil: Klersy, Catherine. Istituti di Ricovero e Cura a Carattere Scientifico. Policlinico San Matteo di Pavia; ItaliaFil: Heller, Paula Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Civaschi, Elisa. Università degli Studi di Pavia; ItaliaFil: Pujol Moix, Nuria. Universitat Autònoma de Barcelona; EspañaFil: Fabris, Fabrizio. Università di Padova; ItaliaFil: Favier, Remi. Inserm; Francia. Armand Trousseau Children’s Hospital; Francia. French Reference Center for Inherited Platelet disorders; FranciaFil: Gresele, Paolo. Università di Perugia; ItaliaFil: Latger Cannard, Véronique. Centre Hospitalo-Universitaire. Service d’Hématologie Biologique; Francia. Reference French Centre. Centre de Compétence Nord-Est des Pathologies Plaquettaires; FranciaFil: Cuker, Adam. University of Pennsylvania; Estados UnidosFil: Nurden, Paquita. Hôpital Xavier Arnozan; FranciaFil: Greinacher, Andreas. Institut für Immunologie und Transfusionsmedizin; AlemaniaFil: Cattaneo, Marco. Università degli Studi di Milano; ItaliaFil: De Candia, Erica. Università Cattolica del Sacro Cuore; ItaliaFil: Pecci, Alessandro. Università degli Studi di Pavia; ItaliaFil: Hurtaud Roux, Marie Françoise. Université Paris Diderot - Paris 7; FranciaFil: Glembotsky, Ana Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Muñiz Diaz, Eduardo. Banc de Sang i Teixits de Catalunya. Immunohematology Department; EspañaFil: Randi, Maria Luigia. Università di Padova; ItaliaFil: Trillot, Nathalie. Centre Hospitalier Régional Universitaire de Lille. Pôle Biologie Pathologie Génétique. Institut d’Hématologie-Transfusion; FranciaFil: Bury, Loredana. Università di Perugia; ItaliaFil: Lecompte, Thomas. Hôpitaux Universitaires de Genève; Suiza. Université de Genève. Faculté de Médecine; SuizaFil: Marconi, Caterina. Università di Bologna; ItaliaFil: Savoia, Anna. Università degli Studi di Trieste; ItaliaFil: Balduini, Carlo L.. Istituti di Ricovero e Cura a Carattere Scientifico Burlo Garofolo. Institute for Maternal and Child Health; Italia. Università degli Studi di Pavia; ItaliaFil: European Hematology Association Scientific Working Group on Thrombocytopenias and Platelet Function Disorders. No especifica