Importance Immune thrombocytopenia purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and nonpregnant patients. Although thrombocytopenia in pregnancy can be caused by more common pathologies such as gestational thrombocytopenia and preeclampsia, ITP can present initially during pregnancy, further complicating diagnosis. Management must be considerate of both the pregnancy itself and the fetus. Objective Review the diagnosis, treatment, and management of ITP in pregnancy based on current recommendations. Evidence Acquisition Review articles, original research, and case studies were utilized. Results Throughout pregnancy, patients are screened for a variety of conditions or disorders of pregnancy. Thrombocytopenia is a common pathology of pregnancy, but ITP is a rare condition that a provider needs to be aware of. After ruling out secondary causes of thrombocytopenia or more common causes such as gestational thrombocytopenia or preeclampsia, ITP should be considered. After diagnosis, treatment options should be discussed and initiated to provide safety for both the mother and fetus. Conclusions After reading this article, the reader will understand the current recommendations regarding the diagnosis, treatment, and management of ITP in pregnancy. Relevance The practitioner will be comfortable treating this condition during pregnancy. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the obstetrician/gynecologist should be better able to describe thrombocytopenia in pregnancy and identify common manifestations; select appropriate tests for evaluation of thrombocytopenia; and explain treatment options for management of ITP during pregnancy and delivery considerations for women with this condition.

Highlights No documented pregnancy has occurred with history of pelvic radiation > 45 Gy prior to this case report. Severe pregnancy complications that can occur after pelvic radiation. Detailed counseling teams to be available to patients considering conception with history of pelvic radiation.

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