Re: ITP/Vaginal delivery

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>I have ITP, and had a spleenectomy in 1987. I had my first appt with
>the perinatal doc yesterday, and her take was that a vaginal birth is
>the current delivery method of choice (my platelet count is normal),
>though years ago, C-sections were common. I'm interested in hearing
>about the pros and cons. I fear that the baby will have a low count
>from getting my antibodies and will be traumatized in the birth canal
>(she did say it would be a no forceps delivery). I've had 4 abdominal
>surgeries, and she thinks its better all around to avoid another
>surgery. She did say I should solicit other opinions and we could talk
>further. So ... any thoughts on if a vaginal delivery is safe? I would
>love to delivery normally, if possible, but I don't want to put my baby
>at risk.

According to a recent study (Low neonatal risk of thrombocytopenia in pregnancy associated with immune thrombocytopenic purpura. Fetal Diagn Ther - 1999 Jul-Aug; 14(4): 216-9), the means of delivery in pregnant women with ITP can be determined solely on the basis of obstetric indications because the incidence of severe fetal and neonatal thrombocytopenia (low platelet count)is very rare, neonatal intracranial hemorrhage is unlikely to be related to the mode of delivery and percutaneous umbilical blood sampling is technically difficult with a risk of fetal death.

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