{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:05:22Z","timestamp":1763535922422,"version":"3.44.0"},"reference-count":4,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,19]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>A 25-year-old woman with a history of immune thrombocytopaenia (ITP) in childhood was referred to haematology clinic for review with a platelet count of 50 \u03bc\/L at 9 weeks gestation, gravida 2, para 0. She developed progressive severe thrombocytopaenia as the pregnancy progressed, with associated bleeding complications. The thrombocytopaenia was refractory to standard therapies. This led to a need for a planned delivery, which was performed via caesarean section under general anaesthetic with platelet transfusion support, Intravenous Immune Globulin (IVIG), high-dose corticosteroid and the thrombopoietin (TPO) mimetic romiplostim. Both the mother and the neonate survived; however, the neonate required treatment for severe prolonged neonatal thrombocytopaenia. The patient subsequently re-presented 15 months later with recurrent ITP complicating another pregnancy, refractory to rituximab but responsive to romiplostim. She had a successful elective caesarean section under epidural anaesthesia, but the neonate once again suffered severe thrombocytopaenia, which was responsive to IVIG.<\/jats:p>","DOI":"10.1136\/bcr-2021-244656","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T12:32:29Z","timestamp":1635424349000},"page":"e244656","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Management of refractory immune thrombocytopaenia in pregnancy"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4310-235X","authenticated-orcid":false,"given":"Jessica M","family":"Heenan","sequence":"first","affiliation":[{"name":"Haematology, Launceston General Hospital, Launceston, Tasmania, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"2025082708001499000_14.10.e244656.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-08-448944"},{"key":"2025082708001499000_14.10.e244656.2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.212845"},{"key":"2025082708001499000_14.10.e244656.3","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.1182\/blood.2020007594","article-title":"Use of thrombopoietin receptor agonists for immune thrombocytopenia in pregnancy: results from a multicenter study","volume":"136","author":"Michel","year":"2020","journal-title":"Blood"},{"key":"2025082708001499000_14.10.e244656.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-01-761262"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244656","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:00:25Z","timestamp":1756306825000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":4,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,28]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bcr-2021-244656"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244656","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}