Navigating Primary Immune Thrombocytopenia During Pregnancy: Management Strategies and Considerations: A Comprehensive Review

Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a low platelet count due to the immune system's destruction of its platelets. During pregnancy, ITP poses significant challenges due to the need to balance maternal and fetal health. This comprehensive review aims to explore the pathophysiology, diagnostic approaches, and management strategies for ITP in pregnant women and discuss emerging treatments and future research directions. A thorough examination of current literature was conducted, including studies on the epidemiology, pathophysiology, diagnostic criteria, and treatment options for ITP in pregnancy. Relevant guidelines and expert consensus were also reviewed to provide a comprehensive understanding of best practices for managing this condition. The management of ITP in pregnancy requires a multidisciplinary approach and individualized treatment plans. First-line therapies include corticosteroids and intravenous immunoglobulin (IVIG), with second-line options such as thrombopoietin receptor agonists and immunosuppressive agents reserved for refractory cases. The choice of treatment depends on the severity of thrombocytopenia, the presence of bleeding symptoms, and gestational age. Special considerations include the risk of neonatal thrombocytopenia and the need for careful monitoring during labor and delivery. Emerging therapies and novel research offer promising advancements, though further studies are needed to validate their safety and efficacy. ITP in pregnancy is a complex condition that necessitates a careful balance between treating the mother and protecting the fetus. The management strategies must be tailored to each patient's needs, minimizing risks and optimizing outcomes. Continued research into the underlying mechanisms and treatment options will be crucial to improving care for pregnant women with ITP. This review provides a detailed synthesis of current knowledge and offers practical guidance for healthcare providers managing ITP during pregnancy.